Provider Demographics
NPI:1710488333
Name:BRIGHTSTAR HEALTH CORP
Entity Type:Organization
Organization Name:BRIGHTSTAR HEALTH CORP
Other - Org Name:HEALTH MATTERS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:OTENG
Authorized Official - Last Name:BOATENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-491-1090
Mailing Address - Street 1:5515 WALDOS BEACH RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-5505
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5515 WALDOS BEACH RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28306-5505
Practice Address - Country:US
Practice Address - Phone:910-491-1090
Practice Address - Fax:910-425-5050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-28
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty PharmacyGroup - Single Specialty