Provider Demographics
NPI:1871505834
Name:BAINBRIDGE ENTERPRISES, INC
Entity Type:Organization
Organization Name:BAINBRIDGE ENTERPRISES, INC
Other - Org Name:STEVE'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:LESLIE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-446-4001
Mailing Address - Street 1:14479 COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661-4433
Mailing Address - Country:US
Mailing Address - Phone:256-446-4001
Mailing Address - Fax:256-446-4004
Practice Address - Street 1:14479 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-4433
Practice Address - Country:US
Practice Address - Phone:256-446-4001
Practice Address - Fax:256-446-4004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7928183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0496940001Medicare ID - Type Unspecified