Organization
BRIDGE MEDICAL SERVICES LLC
Active
Other names
sunrise pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EZEKIEL KEERENG KESITILWE PHARMD (MANAGER)
(928) 230-9812
Entity
Organization
Contact information
Practice address
1955 MCCULLOCH BLVD N # 100, LAKE HAVASU CITY, AZ 86403-5739
(928) 230-9812
Mailing address
PO BOX 1257, LAKE HAVASU CITY, AZ 86405-1257
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
02/11/2019
Last updated
02/11/2019
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