1922049816 NPI number — BRIDGES & JAMES, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922049816 NPI number — BRIDGES & JAMES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRIDGES & JAMES, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922049816
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/15/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 488
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHERAW
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29520-0488
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-537-9550
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 CHESTERFIELD HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHERAW
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29520-7001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-537-9550
Provider Business Practice Location Address Fax Number:
843-537-9550
Provider Enumeration Date:
06/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BRIDGES
Authorized Official First Name:
JONATHAN
Authorized Official Middle Name:
CHRISTOPHER
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
843-537-3221

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X , with the licence number:  2400 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 2400 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7703873 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: DME 178 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".




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