1164555785 NPI number — CENTER POINTE SLEEP ASSOCIATES, LLC

Table of content: (NPI 1164555785)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164555785 NPI number — CENTER POINTE SLEEP ASSOCIATES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTER POINTE SLEEP ASSOCIATES, 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:
1164555785
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/04/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1830 UNION AVE STE B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NATRONA HEIGHTS
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15065-2201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-941-6595
Provider Business Mailing Address Fax Number:
724-941-8694

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
453 VALLEY BROOK ROAD
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
MCMURRAY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15317-3371
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-941-6595
Provider Business Practice Location Address Fax Number:
724-941-6595
Provider Enumeration Date:
03/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
THOMPSON
Authorized Official First Name:
KELLI
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
724-941-6595

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , registered in the state of PA ; 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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