Provider Demographics
NPI:1184879595
Name:BRIDGE MEDICAL DISTRIBUTION NETWORK, LLC
Entity type:Organization
Organization Name:BRIDGE MEDICAL DISTRIBUTION NETWORK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MALCOLM
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:KANTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-277-6690
Mailing Address - Street 1:14 WOLFE LN
Mailing Address - Street 2:
Mailing Address - City:PURCHASE
Mailing Address - State:NY
Mailing Address - Zip Code:10577-1110
Mailing Address - Country:US
Mailing Address - Phone:800-277-6690
Mailing Address - Fax:914-761-2361
Practice Address - Street 1:14 WOLFE LN
Practice Address - Street 2:
Practice Address - City:PURCHASE
Practice Address - State:NY
Practice Address - Zip Code:10577-1110
Practice Address - Country:US
Practice Address - Phone:800-277-6690
Practice Address - Fax:914-761-2361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
No293D00000XLaboratoriesPhysiological Laboratory
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies