# BRIDGETON RX INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Health Care Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417693110
- **Authorized official:** MR. ROSS WAGNER (PRES)
- **Authorized official phone:** (856) 319-5004

## Contact information

- **Practice address:** 14 N PEARL ST STE 101, BRIDGETON, NJ 08302-1902
- **Practice address phone:** (973) 865-6577
- **Mailing address:** 15 RAINTREE CT, HOLMDEL, NJ 07733-2814

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 05/06/2022
- **Last updated:** 01/10/2024