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BRIDGESTONE PHARMACY LLC

Suppliers Pharmacy Mail Order Pharmacy

Provider NPI: 1003354614

Organization Information:
Organization Name:  BRIDGESTONE PHARMACY LLC
Organization is not Subpart
Authorized Official:  BRANDON  SINTZ  PIC/MANAGING MEMBER  615-930-1553

Practice Location:
825 HAMILTON CROSSINGS  ANTIOCH, TN 37013 US
Tel: 615-930-1553  Fax: 615-250-4918

Business Mailing Address:
825 HAMILTON CROSSINGS  ANTIOCH, TN 37013 US
Tel: 615-930-1553  Fax: 615-250-4918

NPI Information:
NPI: 1003354614
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N3336M0002XSuppliers
Pharmacy
Mail Order Pharmacy
N333600000XSuppliers
Pharmacy
Y3336C0003XSuppliers
Pharmacy
TN0000005944

Other Provider Identifiers:

IssuerNumberStateType
PK216847001



American Medical Association 2012 taxonomy code information

Code: 3336C0003X

Type:

Classification:



Definition:



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