Provider Demographics
NPI:1932114543
Name:BRITE PHARMACY INC
Entity Type:Organization
Organization Name:BRITE PHARMACY INC
Other - Org Name:VITALSCRIPT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-424-1101
Mailing Address - Street 1:8319 37TH AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-7320
Mailing Address - Country:US
Mailing Address - Phone:718-424-1101
Mailing Address - Fax:718-424-1299
Practice Address - Street 1:8319 37TH AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7320
Practice Address - Country:US
Practice Address - Phone:718-424-1101
Practice Address - Fax:718-424-1299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2016-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0274043336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02710149Medicaid
2067336OtherPK
NY5561310001Medicare NSC