Provider Demographics
NPI:1225028293
Name:SEABRIGHT PHARMACY INC
Entity Type:Organization
Organization Name:SEABRIGHT PHARMACY INC
Other - Org Name:BAYSHORE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/PRINCIPAL/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:P
Authorized Official - Last Name:STRYKER
Authorized Official - Suffix:
Authorized Official - Credentials:RP
Authorized Official - Phone:732-291-2900
Mailing Address - Street 1:9 BAYSHORE PLZ
Mailing Address - Street 2:HIGHWAY 36
Mailing Address - City:ATLANTIC HIGHLANDS
Mailing Address - State:NJ
Mailing Address - Zip Code:07716-1109
Mailing Address - Country:US
Mailing Address - Phone:732-291-2900
Mailing Address - Fax:732-291-9822
Practice Address - Street 1:2 BAYSHORE PLZ
Practice Address - Street 2:
Practice Address - City:ATLANTIC HIGHLANDS
Practice Address - State:NJ
Practice Address - Zip Code:07716-1109
Practice Address - Country:US
Practice Address - Phone:732-291-2900
Practice Address - Fax:732-291-9822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-21
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS00526100333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3100271OtherNABP
NJ8557403Medicaid
NJ8557403Medicaid