Provider Demographics
NPI:1477995298
Name:BRIDGES, TAYLOR KENDALL (RPH)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:KENDALL
Last Name:BRIDGES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1063 SNOW DRIFT RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA CROSS ROADS
Mailing Address - State:PA
Mailing Address - Zip Code:16914-8348
Mailing Address - Country:US
Mailing Address - Phone:908-309-3156
Mailing Address - Fax:
Practice Address - Street 1:350 POCONO COMMONS
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-8170
Practice Address - Country:US
Practice Address - Phone:570-426-1050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-22
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP447776183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist