1558765925 NPI number — HEALTHY CHILDSMILES

Table of content: MR. DONALD JAMES BRIGHT JR. (NPI 1225267628)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558765925 NPI number — HEALTHY CHILDSMILES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTHY CHILDSMILES
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:
6
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:
1558765925
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/16/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 224
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MULLINS
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29574
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-732-2477
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4504 E HIGHWAY 76
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MULLINS
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29574-7261
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
844-638-7267
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/14/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PARSLEY
Authorized Official First Name:
CHANDA
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
843-732-2477

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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