Healthcare Provider Details

I. General information

NPI: 1699140764
Provider Name (Legal Business Name): CITY LIGHTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2015
Last Update Date: 12/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 MARKET SQ
PITTSBURGH PA
15222-1813
US

IV. Provider business mailing address

6 MARKET SQ
PITTSBURGH PA
15222-1813
US

V. Phone/Fax

Practice location:
  • Phone: 412-881-5466
  • Fax:
Mailing address:
  • Phone: 412-881-5466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberA-00119028F6000
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberA-00119028F6000
License Number StatePA

VIII. Authorized Official

Name: DAWN LILLY
Title or Position: GENERAL MANAGER
Credential:
Phone: 412-414-3374