Organization
BRIGHT LIVES TRANSPORTATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EBONIE BROWN (PRESIDENT)
(919) 916-8100
Entity
Organization
Contact information
Practice address
4913 PROFESSIONAL CT STE 9B, RALEIGH, NC 27609-4913
(252) 367-2288
Mailing address
4913 PROFESSIONAL CT STE 9B, RALEIGH, NC 27609-4913
(252) 367-2288
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
347C00000X
Private Vehicle
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
99999
—
NC
Enumeration date
11/25/2016
Last updated
11/25/2016
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