Provider Demographics
NPI:1881081990
Name:BRIGHT PATH EMS LLC
Entity type:Organization
Organization Name:BRIGHT PATH EMS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:BRYAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:EMT
Authorized Official - Phone:770-351-8284
Mailing Address - Street 1:5855 STEEPLECHASE BLVD
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-7468
Mailing Address - Country:US
Mailing Address - Phone:770-351-8284
Mailing Address - Fax:
Practice Address - Street 1:5855 STEEPLECHASE BLVD
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-7468
Practice Address - Country:US
Practice Address - Phone:770-351-8284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-16
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA058-063416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport