MEDICARE: BRIGHT PHARMACY & MEDICAL SUPPLY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	030330	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2127292	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083922322
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHT PHARMACY & MEDICAL SUPPLY INC

Provider Business Mailing Address
First Line	:	227 BRIGHTON BEACH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235
Country	:	US
Telephone Number	:	718-615-1550
Fax Number	:	718-676-1393

Provider Business Practice Location Address
First Line	:	227 BRIGHTON BEACH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-7406
Country	:	US
Telephone Number	:	718-615-1550
Fax Number	:	718-676-1393

Authorized Official
Title or Position	:	SUPERVISING PHARMACIST
Name	:	ROMAN GARBER
Credential	:
Telephone Number	:	718-615-1550

Provider Enumeration Date	:	09/21/2010
Last Update Date	:	09/19/2025

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