Provider Demographics
NPI:1063304541
Name:BRIGHTPATH TRANSPORT LLC
Entity type:Organization
Organization Name:BRIGHTPATH TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:PRECIOUS
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-779-8124
Mailing Address - Street 1:1916 WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53403-2783
Mailing Address - Country:US
Mailing Address - Phone:414-544-5749
Mailing Address - Fax:414-544-5749
Practice Address - Street 1:1916 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53403-2783
Practice Address - Country:US
Practice Address - Phone:414-544-5749
Practice Address - Fax:414-544-5749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty