Bridgeport Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

SP0552462 Issued in WV

Legal business name

BRIDGEPORT PHARMACY INC

Practice address

527 Medical Park Dr Ste 105
Bridgeport, WV 26330-9009

Phone

(304) 933-3880

Fax

(304) 933-3887

NPI assigned

Jun 25, 2014

Organization subpart

No

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

Authorized official

Name

Muhammad Salman

Title

Owner/ Pharmacy Manager

Phone

(304) 203-4927

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bridgeport Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466035200000",
    "number": "1265847503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DR STE 105",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309009",
            "telephone_number": "304-933-3880",
            "fax_number": "304-933-3887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DR STE 105",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309009",
            "telephone_number": "304-933-3880",
            "fax_number": "304-933-3887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEPORT PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-25",
        "last_updated": "2016-06-16",
        "status": "A",
        "authorized_official_last_name": "SALMAN",
        "authorized_official_first_name": "MUHAMMAD",
        "authorized_official_title_or_position": "OWNER/ PHARMACY MANAGER",
        "authorized_official_telephone_number": "304-203-4927"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WV",
            "license": "SP0552462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2148743",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridgeport Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Bridgeport Physical Therapy Services, Inc.
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• Bridgeport Prescription Shop LLC
• Bridgeport Senior Living, LLC
• Bridgeport Senior Living, LLC

• Community/Retail Pharmacy in Bridgeport, WV
• Providers in Bridgeport, WV by specialty
• Community/Retail Pharmacy in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; 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.