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BRIGHT SKY NUTRITION LLC NPI 1124477104


NPI Information

NPI: 1124477104
Provider Name: BRIGHT SKY NUTRITION, LLC

Former Legal Business Name: SUNSHINE WEIGHT LOSS CLUB, LLC

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
3543 S LONE PINE AVE
SPRINGFIELD, MO
ZIP 65804
Phone: (417) 343-8222
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BRIGHT SKY NUTRITION, LLC is a clinic center in Springfield, MO. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). BRIGHT SKY NUTRITION, LLC NPI is 1124477104. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Sunshine Weight Loss Club, Llc.

The provider's business location address is:

3543 S LONE PINE AVE
SPRINGFIELD, MO
ZIP 65804-854
Phone: (417) 343-8222
Fax: (866) 542-3416

The provider's authorized official is Ladonna Marie Webb .
The authorized official title is Owner/dietitian and has the following contact phone number (417) 343-8222.

The enumeration date for this NPI number is 6/9/2016 and was last updated on 7/6/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/Center2004029834MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11073807384MEDICAIDMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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