MEDBROOK MEDICAL ASSOCIATES INC (NPI# 1649292228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649292228 |
| Entity Type | Organization |
| Organization Name | MEDBROOK MEDICAL ASSOCIATES INC |
| Other Organization Name | MEDBROOK MEDICAL ASSOCI INC PHCY |
| Practice Address |
1370 Johnson Ave Bridgeport WV 26330-1492 |
| Practice Telephone | 3048424233 |
| Practice Fax Number | 3048422574 |
| Mailing Telephone | 3048424233 |
| Mailing Fax Number | 3048422574 |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2010-08-11 |
| Authorized Official Name | KELLY NELSON (MEDICAL DIRECTOR/ PRESIDENT) |
| Authorized Official Telephone | 3048427186 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
SP0552291 | WV | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 6003063000 | 05 | |
| NCPDP PROVIDER IDENTIFICATION NUMBER | 5012048 | 01 |
| Other Name | Type Code |
|---|---|
| MEDBROOK MEDICAL ASSOCI INC PHCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013960632 | Medbrook Medical Associates Inc | Clinic/Center | 1370 Johnson Avenue, Bridgeport, WV 26330-1382 | 2006-05-17 |
| Street Address |
1370 JOHNSON AVE |
| City | BRIDGEPORT |
| State | WV |
| Zip Code | 26330-1492 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619946936 | James J Demarco | Internal Medicine | 1370 Johnson Ave, Ste 203, Bridgeport, WV 26330-1378 | 2006-03-17 |
| 1962036509 | Maria Bridgette Scudere | Nurse Practitioner | 1370 Johnson Ave, Bridgeport, WV 26330-1492 | 2020-02-22 |
| 1841663127 | Carrie Renee Arbogast | Physician Assistant | 1370 Johnson Ave, Ste 102, Bridgeport, WV 26330-1492 | 2015-11-09 |
| 1750674149 | Tammy Lou Yazevac | Physician Assistant | 1370 Johnson Ave, Bridgeport, WV 26330-1492 | 2011-05-18 |
| 1740508779 | Raetta Lynn Wentz | Physician Assistant | 1370 Johnson Ave, Bridgeport, WV 26330-1492 | 2010-05-14 |
| 1023332699 | Jaclyn K Swick | Physician Assistant | 1370 Johnson Ave, Bridgeport, WV 26330-1492 | 2010-03-25 |
| 1750565800 | United Hospital Center, Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1370 Johnson Ave, Suite 201, Bridgeport, WV 26330-1492 | 2007-12-26 |
| 1578692679 | Medbrook Medical Assoc. Inc. | Clinical Medical Laboratory | 1370 Johnson Ave, Bridgeport, WV 26330-1382 | 2007-03-05 |
| 1720142391 | Timothy M Peasak | Emergency Medicine | 1370 Johnson Ave, 1st Floor, Bridgeport, WV 26330 | 2006-12-20 |
| 1922065879 | Carol A Shirey | Internal Medicine | 1370 Johnson Ave, Ste 102, Bridgeport, WV 26330-1492 | 2006-04-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303036 | Gage Mackenzie Chichester | Nurse Anesthetist, Certified Registered | 2673 Medical Park Drive, Bridgeport, WV 26330 | 2020-10-12 |
| 1851914105 | Melany Langhurst | Social Worker | 64 Professional Place, Suite 102, Bridgeport, WV 26330 | 2020-05-21 |
| 1245704980 | Adam Christopher Stonestreet | Social Worker | Community Care of Bridgeport, 65 Professional Place, Bridgeport, WV 26330 | 2019-01-16 |
| 1588146658 | Bridgeport Physical Therapy Services, Inc. | Occupational Therapist | 25 Sweetbrier Lane, Suite 105, Bridgeport, WV 26330 | 2018-09-05 |
| 1275040685 | White Oaks Assisted Living | Assisted Living Facility | 140 Professional Place White Oaks, Bridgeport, WV 26330 | 2018-01-08 |
| 1275049371 | Regional Eye Associates, Inc | Ophthalmology | 220 Southview Drive, Bridgeport, WV 26330 | 2017-12-27 |
| 1528586187 | Savanna Tamia Brown | Social Worker | 65 Professinal Place Suites 101,102103, Bridgeport, WV 26330 | 2017-09-05 |
| 1184079642 | Karla Kay Rinehart | Social Worker | 27 Trovato St., Suite 103, Bridgeport, WV 26330 | 2016-05-03 |
| 1396176756 | Willo Group LLC | Pharmacy | 460 E. Main Street, Bridgeport, WV 26330 | 2013-12-10 |
| 1891031878 | Sherri Michelle Dobson | Occupational Therapy Assistant | 1000 Maplewood Dr, Bridgeport, WV 26330 | 2012-12-20 |
| Find all providers in zip 26330 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952909053 | Payne & Pitts, LLC | Pharmacy | 602 Alabama Avenue, Bridgeport, AL 35740-7513 | 2020-10-12 |
| 1609432459 | Brx LLC | Pharmacy | 319 S Virginia Ave, Bridgeport, WV 26330-1744 | 2019-05-17 |
| 1871027714 | Unity Pharmacy II LLC | Pharmacy | 679 Fairfield Ave, Bridgeport, CT 06604-3906 | 2017-04-18 |
| 1063960755 | Workers First Pharmacy Services LLC | Pharmacy | 207 W 4th St Ste B, Bridgeport, PA 19405-1012 | 2016-09-12 |
| 1265809420 | Ls Health, LLC | Pharmacy | 54 W 4th St, Suite 38, Bridgeport, PA 19405-1009 | 2015-08-24 |
| 1548673940 | Hope Dispensary of Greater Bridgeport | Pharmacy | 752 E Main St # 170, Bridgeport Dept of Health, Bridgeport, CT 06608-2335 | 2014-06-04 |
| 1538445101 | Mountaineer Medical Office Building Pharmacy | Pharmacy | 120 Medical Park Dr Ste 102, Bridgeport, WV 26330-9013 | 2011-10-27 |
| 1093094021 | Right Care Pharmacy Inc | Pharmacy | 2366 Main St, Bridgeport, CT 06606-5339 | 2011-08-09 |
| 1710287602 | Brookshire Grocery Company | Pharmacy | 1203 Us Highway 380, Bridgeport, TX 76426-2087 | 2010-10-26 |
| 1699879510 | Connecticut Cvs Pharmacy, L.L.C. | Pharmacy | 3710 Main St, Bridgeport, CT 06606-3613 | 2006-09-12 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 26330 |
Please comment or provide details below to improve the information on MEDBROOK MEDICAL ASSOCIATES INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.