MEDICARE: BRIGHT HEALTH MANAGEMENT, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center

General Provider Information

NPI Number	:	1548773419
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHT HEALTH MANAGEMENT, INC

Provider Business Mailing Address
First Line	:	42301 MOUND RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48314-3148
Country	:	US
Telephone Number	:	586-932-6303
Fax Number	:	586-932-6304

Provider Business Practice Location Address
First Line	:	42301 MOUND RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48314-3148
Country	:	US
Telephone Number	:	586-932-6303
Fax Number	:	586-932-6304

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	ARAK ISHAQ
Credential	:
Telephone Number	:	586-932-6303

Provider Enumeration Date	:	11/14/2017
Last Update Date	:	06/16/2018

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