Organization Active NPI

Independence Alive & Well Inc

  • Pharmacy
  • Bridgewater, VA
National Provider Identifier
1487792974
Registry record updated Feb 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
0201003486 Issued in VA
Legal business name
INDEPENDENCE ALIVE & WELL INC
Practice address
509 N Main St
Bridgewater, VA 22812-1626
Phone
(540) 828-6000
Fax
(540) 828-2743
NPI assigned
Feb 5, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Patrick Andrew Oshea, RPHNPI 1306901657
Title
Owner
Phone
(540) 828-6000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory

Locations

509 N Main St
Bridgewater, VA 22812
Phone (540) 828-6000

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 0201003486 VA Primary

Addresses

NPPES NPI Registry

Primary practice location

509 N Main St
Bridgewater, VA 22812-1626

Mailing address

509 N Main St
Bridgewater, VA 22812-1626
Phone (540) 828-6000

Other names 1

NPPES NPI Registry
  • Bridge Water Pharmacy Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 16, 2010.

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266278400000",
    "number": "1487792974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 N MAIN ST",
            "city": "BRIDGEWATER",
            "state": "VA",
            "postal_code": "228121626",
            "telephone_number": "540-828-6000",
            "fax_number": "540-828-2743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 N MAIN ST",
            "city": "BRIDGEWATER",
            "state": "VA",
            "postal_code": "228121626",
            "telephone_number": "540-828-6000",
            "fax_number": "540-828-2743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE ALIVE & WELL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2010-02-16",
        "status": "A",
        "authorized_official_last_name": "OSHEA",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-828-6000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "VA",
            "license": "0201003486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridge Water Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bridgewater, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2010; 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.