Provider Demographics
NPI:1578279030
Name:CARE BRIDGE MEDICAL INC.
Entity Type:Organization
Organization Name:CARE BRIDGE MEDICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RANDAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-503-2773
Mailing Address - Street 1:5225 S LOOP 289 STE 202
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-1547
Mailing Address - Country:US
Mailing Address - Phone:806-503-2773
Mailing Address - Fax:
Practice Address - Street 1:2403 46TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79412-1524
Practice Address - Country:US
Practice Address - Phone:806-503-2773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-27
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty