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General NPI Number Information
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NPI Number | 1881081990
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Entity Type | Organization
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Legal Business Name | BRIGHT PATH EMS LLC
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Dates
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Enumeration Date | 04/16/2015
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Last Update Date | 04/16/2015
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Provider Practice Location Address
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Address Line | 5855 STEEPLECHASE BLVD
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City | CUMMING
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State | GA
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Zip | 30040-7468
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Country | US
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Telephone | 770-351-8284
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Fax |
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Provider Business Mailing Address
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Address Line | 5855 STEEPLECHASE BLVD
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City | CUMMING
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State | GA
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Zip | 30040-7468
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Country | US
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Telephone | 770-351-8284
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROBERT E BRYAN JR.
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Credential | EMT
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Telephone | 770-351-8284
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 058-06
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License Number State | GA
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