1801116694 NPI number — TOTAL SLEEP DIAGNOSTICS, INC.

Table of content: (NPI 1801116694)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801116694 NPI number — TOTAL SLEEP DIAGNOSTICS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOTAL SLEEP DIAGNOSTICS, INC.
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:
1801116694
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/03/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1425 GREENWAY DR
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
IRVING
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75038-2447
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-499-2822
Provider Business Mailing Address Fax Number:
469-499-2806

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1720 PEACHTREE ST NW
Provider Second Line Business Practice Location Address:
SUITE 140
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30309-2449
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-611-7310
Provider Business Practice Location Address Fax Number:
469-499-2806
Provider Enumeration Date:
06/03/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GUIDETTI
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
J
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
469-499-2822

Provider Taxonomy Codes

  • Taxonomy code: 261QS1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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