1265764997 NPI number — PROFESSIONAL SLEEP DIAGNOSTICS

Table of content: (NPI 1265764997)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265764997 NPI number — PROFESSIONAL SLEEP DIAGNOSTICS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PROFESSIONAL SLEEP DIAGNOSTICS
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:
1265764997
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/06/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7200 CORPORATE CENTER DR
Provider Second Line Business Mailing Address:
SUITE #600
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33126-1200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-500-2000
Provider Business Mailing Address Fax Number:
305-500-2155

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1771 TATE BLVD SE
Provider Second Line Business Practice Location Address:
SUITE #102
Provider Business Practice Location Address City Name:
HICKORY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28602-4249
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-485-2955
Provider Business Practice Location Address Fax Number:
828-485-2957
Provider Enumeration Date:
02/05/2010

Additional Information

Authorized Official

Authorized Official Last Name:
BARGER
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
E.
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
800-486-2620

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)





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