Provider Demographics
NPI:1003804543
Name:BRIDGES & BRIDGES INC
Entity Type:Organization
Organization Name:BRIDGES & BRIDGES INC
Other - Org Name:THE VILLAGES CLINICAL LABORATORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLIFTON
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRIDGES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:352-751-8906
Mailing Address - Street 1:PO BOX 1337
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:24701-1337
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1501 N US HIGHWAY 441
Practice Address - Street 2:BLDG. 1800, STE 1810
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-8999
Practice Address - Country:US
Practice Address - Phone:352-751-8906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLL9276OtherBCBS OF FL
P00159584OtherRAILROAD MEDICARE
P00159584OtherRAILROAD MEDICARE