Bridgeport Family Pharmacy

LBN: Willo Group
Bridgeport Family Pharmacy is an health care organization with primary practice located at 460 E. Main Street , Bridgeport WV 26330. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Willo Group can be contacted via phone (304) 848-9500, or through Spatafore, Lori R via phone (304) 848-9500.

Contact Information

Primary practice address
460 E. Main Street Bridgeport WV 26330
Phone: (304) 848-9500
Fax: (304) 848-9503
Website:
Map and Directions
Authorized official contact:
Name: Spatafore, Lori R RPH
Phone: (304) 848-9500

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X SP0552461 West Virginia

Profile Details

NPI number 1396176756
LBN Legal business name Willo Group
DBA Doing business as Bridgeport Family Pharmacy
Authorized official Spatafore, Lori R RPH
Entity Organization
Organization subpart 1 No
Enumeration date Dec 10th, 2013
Last updated Apr 30th, 2021 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396176756 NPPES
Other 2143725 PK
MEDICAID 3910001300 PK

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