Provider Demographics
NPI:1215060561
Name:BRIGHT AUDIOLOGY AND SPEECH INC.
Entity type:Organization
Organization Name:BRIGHT AUDIOLOGY AND SPEECH INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIGHT-PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:AUDCCC/A,SEP
Authorized Official - Phone:919-774-3277
Mailing Address - Street 1:1620 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-5662
Mailing Address - Country:US
Mailing Address - Phone:919-774-3277
Mailing Address - Fax:919-771-1643
Practice Address - Street 1:1620 S 3RD ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-5662
Practice Address - Country:US
Practice Address - Phone:919-774-3277
Practice Address - Fax:919-771-1643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2443231H00000X
NC2613235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7210293Medicaid
NC2419002AMedicare PIN