Provider Demographics
NPI:1497345029
Name:BRIGHTWAY MOBILITY LLC
Entity Type:Organization
Organization Name:BRIGHTWAY MOBILITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:E
Authorized Official - Last Name:PHIPPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-800-9902
Mailing Address - Street 1:1525 S BLOUNT ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-2507
Mailing Address - Country:US
Mailing Address - Phone:919-800-9902
Mailing Address - Fax:888-643-2044
Practice Address - Street 1:1525 S BLOUNT ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-2507
Practice Address - Country:US
Practice Address - Phone:919-800-9902
Practice Address - Fax:888-643-2044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment