Provider Demographics
NPI:1679808133
Name:ADBRIGHT PHARMACY INCORPORATED
Entity type:Organization
Organization Name:ADBRIGHT PHARMACY INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/ PIC
Authorized Official - Prefix:
Authorized Official - First Name:BRIGHT
Authorized Official - Middle Name:
Authorized Official - Last Name:WOKOCHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-687-8639
Mailing Address - Street 1:4601 AVENUE H
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-2038
Mailing Address - Country:US
Mailing Address - Phone:281-341-7980
Mailing Address - Fax:281-232-5314
Practice Address - Street 1:4601 AVENUE H STE 1
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-2038
Practice Address - Country:US
Practice Address - Phone:281-341-7980
Practice Address - Fax:281-232-5314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-15
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX266303336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4554324OtherNCPDP PROVIDER IDENTIFICATION NUMBER