Provider Demographics
NPI:1003345026
Name:BRIDGEWATER HEALTH SUPPLIES LLC
Entity Type:Organization
Organization Name:BRIDGEWATER HEALTH SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-579-5308
Mailing Address - Street 1:116A SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:OYSTER BAY
Mailing Address - State:NY
Mailing Address - Zip Code:11771-2221
Mailing Address - Country:US
Mailing Address - Phone:631-579-5308
Mailing Address - Fax:
Practice Address - Street 1:116A SOUTH ST
Practice Address - Street 2:
Practice Address - City:OYSTER BAY
Practice Address - State:NY
Practice Address - Zip Code:11771-2221
Practice Address - Country:US
Practice Address - Phone:631-579-5308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies