Healthcare Provider Details

I. General information

NPI: 1528971397
Provider Name (Legal Business Name): BRIDGEWATER RX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 STATE ROUTE 28
BRIDGEWATER NJ
08807-2401
US

IV. Provider business mailing address

12 COUNTRY MEADOW RD
HACKETTSTOWN NJ
07840-5205
US

V. Phone/Fax

Practice location:
  • Phone: 908-800-1538
  • Fax:
Mailing address:
  • Phone: 862-304-8703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: NIRAJ RANA
Title or Position: OWNER
Credential:
Phone: 862-304-8703