Provider Demographics
NPI:1346815701
Name:BRIDGEPORT CLAIMS, LLC
Entity Type:Organization
Organization Name:BRIDGEPORT CLAIMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:CONDIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-480-5630
Mailing Address - Street 1:PO BOX 249
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84091-0249
Mailing Address - Country:US
Mailing Address - Phone:844-480-5630
Mailing Address - Fax:844-480-5631
Practice Address - Street 1:6699 S 1300 E STE 250
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-7242
Practice Address - Country:US
Practice Address - Phone:844-480-5630
Practice Address - Fax:844-480-5631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy