Provider Demographics
NPI:1285146449
Name:BAINBRIDGE, DEBORAH (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:
Last Name:BAINBRIDGE
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20717 CASTLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:96022-9421
Mailing Address - Country:US
Mailing Address - Phone:530-347-4993
Mailing Address - Fax:
Practice Address - Street 1:20635 GAS POINT ROAD
Practice Address - Street 2:P.O. BOX 588
Practice Address - City:COTTONWOOD
Practice Address - State:CA
Practice Address - Zip Code:96022
Practice Address - Country:US
Practice Address - Phone:530-347-3721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-27
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53543183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist