Provider Demographics
NPI:1437289600
Name:BRIGHT HORIZON IMAGING LLC
Entity Type:Organization
Organization Name:BRIGHT HORIZON IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TECHNICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CALVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-860-2576
Mailing Address - Street 1:3635 BRASELTON HWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-1068
Mailing Address - Country:US
Mailing Address - Phone:770-771-6930
Mailing Address - Fax:
Practice Address - Street 1:3635 BRASELTON HWY
Practice Address - Street 2:SUITE A
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-1068
Practice Address - Country:US
Practice Address - Phone:866-860-2576
Practice Address - Fax:770-771-6931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology