Provider Demographics
NPI:1386362242
Name:BRIDGECARE CLINICAL SERVICES, LLC
Entity type:Organization
Organization Name:BRIDGECARE CLINICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GETOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-600-1567
Mailing Address - Street 1:3623 W WOOLBRIGHT RD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-7244
Mailing Address - Country:US
Mailing Address - Phone:561-600-1567
Mailing Address - Fax:
Practice Address - Street 1:3631 W WOOLBRIGHT RD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-7244
Practice Address - Country:US
Practice Address - Phone:561-600-1567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-17
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Single Specialty