Provider Demographics
NPI:1386860922
Name:BRIGHT STAR PHARMACY DISCOUNT INC
Entity Type:Organization
Organization Name:BRIGHT STAR PHARMACY DISCOUNT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MILENA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTELLANOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-826-9799
Mailing Address - Street 1:2350 W 84TH ST
Mailing Address - Street 2:7
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5575
Mailing Address - Country:US
Mailing Address - Phone:305-826-9799
Mailing Address - Fax:305-826-9775
Practice Address - Street 1:2350 W 84TH ST
Practice Address - Street 2:7
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5575
Practice Address - Country:US
Practice Address - Phone:305-826-9799
Practice Address - Fax:305-826-9775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherEIN
FL5140600001Medicare NSC