Provider Demographics
NPI:1487235651
Name:BRIGHTBILL, MATTHEW J (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:J
Last Name:BRIGHTBILL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 ENTERPRISE RD
Mailing Address - Street 2:
Mailing Address - City:EAST PETERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17520
Mailing Address - Country:US
Mailing Address - Phone:717-925-2380
Mailing Address - Fax:
Practice Address - Street 1:1110 ENTERPRISE RD
Practice Address - Street 2:
Practice Address - City:EAST PETERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17520-1604
Practice Address - Country:US
Practice Address - Phone:717-925-2380
Practice Address - Fax:717-925-2399
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP442214183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARPI002406OtherAUTH TO ADMINISTER INJECTABLES
PARP442214OtherPHARMACIST LICENSE