Bridgewater Health Supplies LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

BRIDGEWATER HEALTH SUPPLIES LLC

Practice address

2605 Texas Blvd Ste 102
Texarkana, TX 75503-4161

Phone

(903) 255-0097

Fax

(516) 908-4383

NPI assigned

Sep 23, 2020

Last updated

Feb 3, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

BRIDGEWATER HEALTH SUPPLIES LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Steven Franey

Title

Authorized Official

Phone

(631) 579-5308

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Bridgewater Health Supplies LLC

  • Durable Medical Equipment & Medical Supplies
  • Oyster Bay, NY
  • NPI 1003345026

  8224388855

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Bridgewater Health Supplies LLC2 organizations share this tax ID, including this one

Part of

Bridgewater Health Supplies LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Bridgewater Health Supplies LLC

  • Durable Medical Equipment & Medical Supplies
  • Oyster Bay, NY
  • NPI 1003345026
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706918400000",
    "number": "1205443371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 TEXAS BLVD STE 102",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755034161",
            "telephone_number": "903-255-0097",
            "fax_number": "516-908-4383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 TEXAS BLVD STE 102",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755034161",
            "telephone_number": "903-255-0097",
            "fax_number": "516-908-4383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEWATER HEALTH SUPPLIES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRIDGEWATER HEALTH SUPPLIES LLC",
        "enumeration_date": "2020-09-23",
        "last_updated": "2024-02-03",
        "certification_date": "2024-02-03",
        "status": "A",
        "authorized_official_last_name": "FRANEY",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "631-579-5308",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Brantley, FNP
• Terry Vincent Braswell, D.D.S.
• Rudy Maeda Braza, M.D.
• Brent Bultemeier PA
• Forestt Bridges
• Brim Healthcare of Texas LLC
• Brim Healthcare of Texas LLC
• Brim Healthcare of Texas LLC
• Jeri Grace Brocker, FNP
• Brookdale Senior Living Communities, Inc. (Brookdale Texarkana)

• Durable Medical Equipment & Medical Supplies in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.