MEDICARE: BRIGHT STAR PHARMACY DISCOUNT 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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1386860922
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHT STAR PHARMACY DISCOUNT INC

Provider Business Mailing Address
First Line	:	2350 W 84TH ST
Second Line	:	7
City	:	HIALEAH
State	:	FL
Zip	:	33016-5575
Country	:	US
Telephone Number	:	305-826-9799
Fax Number	:	305-826-9775

Provider Business Practice Location Address
First Line	:	2350 W 84TH ST
Second Line	:	7
City	:	HIALEAH
State	:	FL
Zip	:	33016-5575
Country	:	US
Telephone Number	:	305-826-9799
Fax Number	:	305-826-9775

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MILENA CASTELLANOS
Credential	:
Telephone Number	:	305-826-9799

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	04/20/2008

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