Provider Demographics
NPI:1841270527
Name:BAINBRIDGE, CHARLES VINCENT (PHARMD,RPH)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:VINCENT
Last Name:BAINBRIDGE
Suffix:
Gender:M
Credentials:PHARMD,RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 HEARTHSTONE RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-4303
Mailing Address - Country:US
Mailing Address - Phone:973-284-0715
Mailing Address - Fax:973-284-0715
Practice Address - Street 1:63 HEARTHSTONE RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-4303
Practice Address - Country:US
Practice Address - Phone:973-284-0715
Practice Address - Fax:973-284-0715
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJR170811835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy