Provider Demographics
NPI:1861677304
Name:CUSUMANO, BRIDGET SCARBORO (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:BRIDGET
Middle Name:SCARBORO
Last Name:CUSUMANO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S FRANKLIN ST STE 102
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-2797
Mailing Address - Country:US
Mailing Address - Phone:919-556-2757
Mailing Address - Fax:919-556-2757
Practice Address - Street 1:900 S FRANKLIN ST STE 102
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-2797
Practice Address - Country:US
Practice Address - Phone:919-556-2757
Practice Address - Fax:919-556-2757
Is Sole Proprietor?:No
Enumeration Date:2008-01-03
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18983183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist