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General NPI Number Information
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NPI Number | 1770070278
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Entity Type | Organization
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Legal Business Name | BRIGHTVIEW3333,LLC
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Dates
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Enumeration Date | 04/19/2018
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Last Update Date | 05/09/2018
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Provider Practice Location Address
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Address Line | 3333 OLD MILTON PKWY STE 100
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City | ALPHARETTA
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State | GA
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Zip | 30005-4437
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Country | US
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Telephone | 404-476-4642
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Fax |
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Provider Business Mailing Address
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Address Line | 3333 OLD MILTON PKWY STE 100
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City | ALPHARETTA
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State | GA
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Zip | 30005-4437
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Country | US
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Telephone | 404-476-4642
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Fax |
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Authorized Official
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Title or Position | AREA PRESIDENT
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Name | MR. CHARLES L ADAMS
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Credential |
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Telephone | 706-835-6945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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