Provider Demographics
NPI:1861247736
Name:BAINBRIDGE PHARMACY INC.
Entity type:Organization
Organization Name:BAINBRIDGE PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:F
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-246-7200
Mailing Address - Street 1:1420 E EVANS ST
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:39819-4336
Mailing Address - Country:US
Mailing Address - Phone:229-246-7200
Mailing Address - Fax:229-246-6210
Practice Address - Street 1:1420 E EVANS ST
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:39819-4336
Practice Address - Country:US
Practice Address - Phone:229-246-7200
Practice Address - Fax:229-246-6210
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAINBRIDGE PHARMACY INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy