Organization
BRIDGEWAY MEDICATION AND SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LATOYA D. GREEN (OWNER)
(704) 208-1706
Entity
Organization
Contact information
Practice address
834 TYVOLA RD STE 112, CHARLOTTE, NC 28217-3542
(704) 208-1706
Mailing address
834 TYVOLA RD STE 112, CHARLOTTE, NC 28217-3542
(704) 208-1706
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/29/2026
Last updated
06/29/2026
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