MEDICARE: BRIDGINGLIFE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician

General Provider Information

NPI Number	:	1447118245
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIDGINGLIFE, INC

Provider Business Mailing Address
First Line	:	200 MEMORIAL AVE
Second Line	:	PAYOR CRED DEPT
City	:	WESTMINSTER
State	:	MD
Zip	:	21157-5726
Country	:	US
Telephone Number	:	410-871-6846
Fax Number	:	410-871-6516

Provider Business Practice Location Address
First Line	:	1920 ROSEMONT AVE
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21702-8249
Country	:	US
Telephone Number	:	410-871-8000
Fax Number	:	410-871-7216

Authorized Official
Title or Position	:	VP CFO
Name	:	MICHAEL MYERS
Credential	:
Telephone Number	:	410-871-6816

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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