1659769446 NPI number — BRIGHTVIEW, LLC

Table of content: (NPI 1659769446)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659769446 NPI number — BRIGHTVIEW, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRIGHTVIEW, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659769446
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/16/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4600 MONTGOMERY RD STE 400
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45212-2600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
833-510-4357
Provider Business Mailing Address Fax Number:
866-460-2997

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
446 MORGAN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45206-2348
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-834-7063
Provider Business Practice Location Address Fax Number:
513-873-1567
Provider Enumeration Date:
12/31/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
NIEMAN
Authorized Official First Name:
AMY
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
DIRECTOR OF CREDENTIALING
Authorized Official Telephone Number:
833-510-4357

Provider Taxonomy Codes

  • Taxonomy code: 207RA0401X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM2800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0405X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 291U00000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0124774 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100629940 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".