Dr. Bryan John Bridgford, PharmD
Pharmacist in Joplin, MO. Individual provider (NPI-1).
NPI number1073115457
StatusActive
Last updated in NPPESNov 11, 2020
Details
- NPI
- 1073115457
- Entity type
- Individual (NPI-1)
- Name
- Dr. Bryan John Bridgford
- Credential
- PharmD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Nov 11, 2020
- Certification date
- Nov 11, 2020
- Last updated
- Nov 11, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | 2014021627 | MO | Yes |
Practice location
2426 S Maiden LnJoplin, MO 64804-0348
Phone 417-206-0560 · Fax 417-206-0559
Mailing address
2426 S Maiden LnJoplin, MO 64804-0348
Phone 417-206-0560 · Fax 417-206-0559
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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