Provider Demographics
NPI:1184931396
Name:LIN, BORGIUN BRIDGETT (RPH)
Entity type:Individual
Prefix:
First Name:BORGIUN
Middle Name:BRIDGETT
Last Name:LIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6924 SANDY CREEK CT
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1747
Mailing Address - Country:US
Mailing Address - Phone:410-531-6468
Mailing Address - Fax:
Practice Address - Street 1:8601 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-4176
Practice Address - Country:US
Practice Address - Phone:410-480-1377
Practice Address - Fax:410-480-3927
Is Sole Proprietor?:No
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14251183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist