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General NPI Number Information
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NPI Number | 1013811439
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Entity Type | Organization
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Legal Business Name | BRIDGEWATER SOLUTIONS INC
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Dates
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Enumeration Date | 10/07/2026
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Last Update Date | 10/07/2026
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Provider Practice Location Address
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Address Line | 2730 PEACHTREE INDUSTRIAL BLVD STE 150
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City | DULUTH
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State | GA
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Zip | 30097
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Country | US
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Telephone | 943-204-7580
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Fax |
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Provider Business Mailing Address
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Address Line | 175 N MAIN ST
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City | ALPHARETTA
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State | GA
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Zip | 30009-3622
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Country | US
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Telephone | 943-204-7580
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HARICHARANTEJA MADDURI
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Credential |
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Telephone | 943-204-7580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State | NULL
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