Provider Demographics
NPI:1194453993
Name:OLD BRIDGE RX, LLC
Entity type:Organization
Organization Name:OLD BRIDGE RX, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NALINIBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-254-7800
Mailing Address - Street 1:15 ROUTE 516
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-1402
Mailing Address - Country:US
Mailing Address - Phone:732-254-7800
Mailing Address - Fax:732-651-7685
Practice Address - Street 1:15 ROUTE 516
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-1402
Practice Address - Country:US
Practice Address - Phone:732-254-7800
Practice Address - Fax:732-651-7685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-10
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy