Provider Demographics
NPI:1730311432
Name:BRIDGES & JAMES INC
Entity Type:Organization
Organization Name:BRIDGES & JAMES INC
Other - Org Name:WANNAMAKER DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIDGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-537-3221
Mailing Address - Street 1:PO BOX 527
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:SC
Mailing Address - Zip Code:29709-0527
Mailing Address - Country:US
Mailing Address - Phone:843-623-2999
Mailing Address - Fax:
Practice Address - Street 1:107 WEST BLVD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:SC
Practice Address - Zip Code:29709-1528
Practice Address - Country:US
Practice Address - Phone:843-623-2999
Practice Address - Fax:843-623-3615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-13
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC104983336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0920550002OtherMEDICARE PTAN
4229084OtherNCPDP PROVIDER IDENTIFICATION NUMBER