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34.195.146.172  Public Scan

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Submission: On August 08 via manual from US — Scanned from DE

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Question 1
1

Hello! Welcome to brightscrip pharmacy registration. brightscrip is a copay
processor exclusively for copay assistance programs using BIN 022816.

brightscrip is owned and operated by Monarch Specialty Group, LLC. We built and
operate our own claims processor and pay pharmacies directly through ACH. Please
complete the following information for us to configure your pharmacy for payment
and reporting setup.

What's your pharmacy NPI?This question is required.*



OK
press Enter ↵
Question 2
2

What is your Pharmacy Legal Name?This question is required.*



OK
press Enter ↵


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