Provider Demographics
NPI:1609289933
Name:BRIGHT, PHILIP (PHARM D)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:BRIGHT
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 E BOISE AVE
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-5118
Mailing Address - Country:US
Mailing Address - Phone:208-336-8340
Mailing Address - Fax:
Practice Address - Street 1:660 E BOISE AVE
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-5118
Practice Address - Country:US
Practice Address - Phone:208-336-8340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-04
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP6703183500000X
ORRPH-0013530183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist