Organization
BRIDGEMILL FAMILY PHARMACY LLC
Active
Other names
BRIDGEMILL FAMILY PHARMACY LLC
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER SMITH PHARM.D. (PRESIDENT)
(770) 720-0300
Entity
Organization
Contact information
Practice address
10511 BELLS FERRY RD, STE 600, CANTON, GA 30114-4258
(770) 720-0300
(770) 720-0373
Mailing address
10511 BELLS FERRY RD, STE 600, CANTON, GA 30114-4258
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009063
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154830
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
653407859A
—
GA
Enumeration date
09/12/2006
Last updated
03/16/2009
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