Bridge Medical Supply, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

4012349-2 Issued in MN

Legal business name

BRIDGE MEDICAL SUPPLY, INC.

Practice address

2615 E Franklin Ave
Minneapolis, MN 55406-1103

Phone

(612) 332-2280

Fax

(612) 333-1445

NPI assigned

Mar 6, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Idris H Mohamed

Title

Owner/Ceo

Phone

(612) 332-2280

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374451200000",
    "number": "1245504489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 E FRANKLIN AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554061103",
            "telephone_number": "612-332-2280",
            "fax_number": "612-333-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 E FRANKLIN AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554061103",
            "telephone_number": "612-332-2280",
            "fax_number": "612-333-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE MEDICAL SUPPLY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-06",
        "last_updated": "2013-07-22",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "IDRIS",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "612-332-2280",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MN",
            "license": "4012349-2",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "MN",
            "license": "4012349-2",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Durable Medical Equipment & Medical Supplies in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.