Provider Demographics
NPI:1790979136
Name:GREEN SPRING PATIENT FIRST SERIES
Entity Type:Organization
Organization Name:GREEN SPRING PATIENT FIRST SERIES
Other - Org Name:PATIENT FIRST BAYVIEW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHARMACY SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:BRIDGERS
Authorized Official - Suffix:III
Authorized Official - Credentials:RPH
Authorized Official - Phone:804-822-4383
Mailing Address - Street 1:5000 COX RD
Mailing Address - Street 2:SUITE 100 PATIENT FIRST
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060
Mailing Address - Country:US
Mailing Address - Phone:804-822-4383
Mailing Address - Fax:804-965-0987
Practice Address - Street 1:5100 EASTERN AVENUE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224
Practice Address - Country:US
Practice Address - Phone:410-814-4500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREEN SPRING PATIENT FIRST SERIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site