Provider Demographics
NPI:1033419973
Name:BRIGHTCHOICE MEDICAL, INC.
Entity Type:Organization
Organization Name:BRIGHTCHOICE MEDICAL, INC.
Other - Org Name:BRIGHTCHOICE MEDICAL EQUIPMENT & SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:VITALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-800-9252
Mailing Address - Street 1:7373 HODGSON MEMORIAL DR
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-1595
Mailing Address - Country:US
Mailing Address - Phone:912-800-9280
Mailing Address - Fax:
Practice Address - Street 1:7373 HODGSON MEMORIAL DR
Practice Address - Street 2:SUITE 3A
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-1595
Practice Address - Country:US
Practice Address - Phone:888-878-6992
Practice Address - Fax:888-878-9542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-26
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC007274013332B00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6469000002Medicare NSC