Provider Demographics
NPI:1033586649
Name:FORD, BRIDGET ANN (PHARMD (PST021220)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:ANN
Last Name:FORD
Suffix:
Gender:F
Credentials:PHARMD (PST021220
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4612 GRAMMAR AVE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-3302
Mailing Address - Country:US
Mailing Address - Phone:504-427-9747
Mailing Address - Fax:
Practice Address - Street 1:2300 W THOMAS ST
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-2830
Practice Address - Country:US
Practice Address - Phone:985-345-3448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-31
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.021220183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist