Bridge Healthcare Pharmacy LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

BRIDGE HEALTHCARE PHARMACY LLC

Practice address

658 E Main St
Centreville, MI 49032-9627

Phone

(269) 467-3510

NPI assigned

Jun 23, 2022

Last updated

Jun 23, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Dabaja, PHARMDNPI 1043561723

Title

Vice President

Phone

(269) 553-5000

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Dabaja

  • Pharmacist
  • Kalamazoo, MI
  • NPI 1043561723
  Authorized official Same address or phone
• Mark Edward Montcalm, PHARM.D.

  • Pharmacist
  • Centreville, MI
  • NPI 1255663449
  NPD (past)

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655942400000",
    "number": "1750012365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22",
            "city": "NAZARETH",
            "state": "MI",
            "postal_code": "490740022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 E MAIN ST",
            "city": "CENTREVILLE",
            "state": "MI",
            "postal_code": "490329627",
            "telephone_number": "269-467-3510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE HEALTHCARE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A",
        "authorized_official_last_name": "DABAJA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "269-553-5000",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandi Bontrager
• Bryann Books, LMSW
• Brandi Lynn Boven
• Elizabeth Margaret Brennan, LMSW, D-PC
• Bridge Healthcare Pharmacy LLC
• Madilyn Elizabeth Brink, BSW
• Shannon Brochey
• Macy Quynn Brown
• Martha D Brown, MSW
• Barbara Pearl Bungart, MA LPC MITS

• Long Term Care Pharmacy in Centreville, MI
• Providers in Centreville, MI by specialty
• Long Term Care Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.