| NPI | 1851717557 |
|---|---|
| Doing Business As | COMMUNITY PHARMACY OF BRIDGEPORT |
| Entity Type | Organization |
| Authorized Contact | THOMAS J RAVIS PIC/Owner 304-695-0572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2014-03-05 |
| Last Update Date | 2014-03-05 |