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NPI Code Detail

MEDICARE: THE BRIDGEWAY, LLC

MEDICARE: THE BRIDGEWAY, LLC
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
1283Q00000XPsychiatric Hospital2559AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
257226OTHERARBLUE CROSS/BLUESHIELD OF AR

General Provider Information

NPI Number : 1962473306
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE BRIDGEWAY, LLC
Provider Business Mailing Address
First Line : 21 BRIDGEWAY RD
Second Line :
City : NORTH LITTLE ROCK
State : AR
Zip : 72113-9514
Country : US
Telephone Number : 501-771-1500
Fax Number :
Provider Business Practice Location Address
First Line : 21 BRIDGEWAY RD
Second Line :
City : NORTH LITTLE ROCK
State : AR
Zip : 72113-9514
Country : US
Telephone Number : 501-771-1500
Fax Number :
Authorized Official
Title or Position : CFO/SR VP
Name : STEVE FILTON
Credential :
Telephone Number : 610-768-3300
Provider Enumeration Date : 02/01/2006
Last Update Date : 06/01/2015

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Directions to “THE BRIDGEWAY, LLC ” Practice Location

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