1366697484 NPI number — SLEEP SOLUTIONS OF THE WESTBANK

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366697484 NPI number — SLEEP SOLUTIONS OF THE WESTBANK

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SLEEP SOLUTIONS OF THE WESTBANK
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:
1366697484
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/03/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 699
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MADISONVILLE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70447
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
985-875-7557
Provider Business Mailing Address Fax Number:
985-875-0595

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4700 WICHERS DR.
Provider Second Line Business Practice Location Address:
SUITE 208
Provider Business Practice Location Address City Name:
MARRERO
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70072
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-355-4188
Provider Business Practice Location Address Fax Number:
504-355-4189
Provider Enumeration Date:
11/18/2008

Additional Information

Authorized Official

Authorized Official Last Name:
LAVIN
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
E.
Authorized Official Title or Position:
OFFICER/DIRECTOR
Authorized Official Telephone Number:
985-875-7557

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • 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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