Provider Demographics
NPI:1609057116
Name:DRUGFAIR OF BRIDGEWATER
Entity Type:Organization
Organization Name:DRUGFAIR OF BRIDGEWATER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P. PHARMACY
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:MCGINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-748-8900
Mailing Address - Street 1:481 EAST UNION AVE 28
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:481 EAST UNION AVE 28
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807
Practice Address - Country:US
Practice Address - Phone:908-722-7001
Practice Address - Fax:908-722-7006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
NJ28RS006751003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
3194812OtherOTHER ID NUMBER
3194812OtherOTHER ID NUMBER