Provider Demographics
NPI:1891240792
Name:BRIGHT PHARMACY GROUP, INC
Entity Type:Organization
Organization Name:BRIGHT PHARMACY GROUP, INC
Other - Org Name:BRIGHT PLAZA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TOBIAS
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-943-7500
Mailing Address - Street 1:15725 WHITTIER BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-2347
Mailing Address - Country:US
Mailing Address - Phone:562-943-7500
Mailing Address - Fax:562-947-0446
Practice Address - Street 1:15725 WHITTIER BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-2347
Practice Address - Country:US
Practice Address - Phone:562-943-7500
Practice Address - Fax:562-947-0446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-20
Last Update Date:2016-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA533633336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy