Healthcare Provider Details

I. General information

NPI: 1013839638
Provider Name (Legal Business Name): BRIDGELINE TRANSIT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 MOSBY CROSSING DR APT 3409
CHARLOTTE NC
28213-0258
US

IV. Provider business mailing address

714 MOSBY CROSSING DR APT 3409
CHARLOTTE NC
28213-0258
US

V. Phone/Fax

Practice location:
  • Phone: 980-215-0354
  • Fax:
Mailing address:
  • Phone: 980-215-0354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: ALLEN LEE JOHNSON
Title or Position: CEO
Credential:
Phone: 347-932-8496