Provider Demographics
NPI:1700842465
Name:BRIDGES, SUZANNE WILKIE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:WILKIE
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1241 RED OAK LN
Mailing Address - Street 2:
Mailing Address - City:WINSTON-SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-4442
Mailing Address - Country:US
Mailing Address - Phone:336-765-6007
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF VETERAN'S AFFAIRS
Practice Address - Street 2:190 KIMEL PARK
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103
Practice Address - Country:US
Practice Address - Phone:336-768-3296
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6010183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist