Bridge City Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

25457 Issued in TX

Legal business name

BRIDGE CITY PHARMACY LLC

Doing business as

Bridge City Family Pharmacy

Practice address

1910 Texas Ave
Bridge City, TX 77611-2834

Phone

(409) 735-5555

Fax

(409) 735-7018

NPI assigned

Apr 19, 2007

Organization subpart

No

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

Authorized official

Name

Trey Haney

Title

Manager

Phone

(409) 769-2406

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Bridge City Family Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

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

• Donald Baker, RPH

  • Pharmacist
  • Bridge City, TX
  • NPI 1528881455
  NPD (past)

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631145600000",
    "number": "1982821088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 TEXAS AVE",
            "city": "BRIDGE CITY",
            "state": "TX",
            "postal_code": "776112834",
            "telephone_number": "409-735-5555",
            "fax_number": "409-735-7018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 TEXAS AVE",
            "city": "BRIDGE CITY",
            "state": "TX",
            "postal_code": "776112834",
            "telephone_number": "409-735-5555",
            "fax_number": "409-735-7018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE CITY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A",
        "authorized_official_last_name": "HANEY",
        "authorized_official_first_name": "TREY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "409-769-2406"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "25457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2100890",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149070",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridge City Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bridge City Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelly Melissa Bock, NP-C
• Brytni Nicole Borel, AUD.
• Bridge City Family Dentistry, PLLC (Bridge City Family Dentistry)
• Bridge City Isd
• Bridge City Occupational Rehabilitation and Pain Management, Inc. (Bridge City Physical Therapy and Pain Management)
• Cardinal Chiropractic
• Henok Chichiso
• Yooshun Chung, DMD
• David O Olson, DDS, PC
• Dr. Heidi B. Doucet P.L.L.C.

• Community/Retail Pharmacy in Bridge City, TX
• Providers in Bridge City, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.