Provider Demographics
NPI:1801024179
Name:BRIGHT RX INC
Entity Type:Organization
Organization Name:BRIGHT RX INC
Other - Org Name:BUFFALO DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-953-9083
Mailing Address - Street 1:183 BUFFALO AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-2426
Mailing Address - Country:US
Mailing Address - Phone:718-953-9083
Mailing Address - Fax:718-953-9087
Practice Address - Street 1:183 BUFFALO AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-2426
Practice Address - Country:US
Practice Address - Phone:718-953-9083
Practice Address - Fax:718-953-9087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-25
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0298923336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3364899OtherNCPDP PROVIDER IDENTIFICATION NUMBER
3364899OtherNCPDP PROVIDER IDENTIFICATION NUMBER