1194828160 NPI number — REST ASSURED SLEEP CENTERS LLC

Table of content: DR. JORDAN ECKER DDS, MD (NPI 1083118533)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194828160 NPI number — REST ASSURED SLEEP CENTERS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REST ASSURED SLEEP CENTERS 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:
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:
1194828160
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2629 RIVA ROAD
Provider Second Line Business Mailing Address:
SUITE 108
Provider Business Mailing Address City Name:
ANNAPOLIS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21401
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-897-8445
Provider Business Mailing Address Fax Number:
410-897-8448

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2401 BRANDERMILL BLVD
Provider Second Line Business Practice Location Address:
SUITE 230A
Provider Business Practice Location Address City Name:
GAMBRILLS
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-897-8445
Provider Business Practice Location Address Fax Number:
410-897-8448
Provider Enumeration Date:
09/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
AKINNAGBE
Authorized Official First Name:
JUME
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
410-897-8445

Provider Taxonomy Codes

  • Taxonomy code: 261QS1200X , with the licence number:  11658041 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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