Active NPI
Bridger Pathology Laboratories Inc. P.a.
- Clinical Medical Laboratory
- Montgomery, AL
National Provider Identifier
1720034754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- BRIDGER PATHOLOGY LABORATORIES INC. P.A.
- Practice address
- 2055 Normandie Dr
Suite 208
Montgomery, AL 36111-2732 - Phone
- (334) 288-4963
- Fax
- (334) 288-4250
- NPI assigned
- May 25, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. William M Bridger
- Title
- President
- Phone
- (334) 288-4963
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
2055 Normandie Dr
Suite 208
Montgomery, AL 36111-2732
Mailing address
2055 Normandie Dr
Suite 208
Montgomery, AL 36111-2732
Phone (334) 288-4963
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51076642 | Other | AL | BLUE CROSS PROVIDER NUMBE |
| 51052284 | Other | AL | BLUE CROSS PROVIDER NUMBE |
| 51076442 | Medicaid | AL | |
| 51052284 | Medicaid | AL |
National Provider Directory
National Provider Directory- Tax ID family
- Bridger Pathology Laboratores PA
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinical Medical Laboratory
- Prattville, AL
- NPI 1497826036
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1720034754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2055 NORMANDIE DR",
"address_2": "SUITE 208",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361112732",
"telephone_number": "334-288-4963",
"fax_number": "334-288-4250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2055 NORMANDIE DR",
"address_2": "SUITE 208",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361112732",
"telephone_number": "334-288-4963",
"fax_number": "334-288-4250"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRIDGER PATHOLOGY LABORATORIES INC. P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-25",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "BRIDGER",
"authorized_official_first_name": "WILLIAM",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "334-288-4963",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROVIDER NUMBE",
"identifier": "51076642",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROVIDER NUMBE",
"identifier": "51052284",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "51076442",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "51052284",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.