1184176950 NPI number — SLEEP WELL, INC

Table of content: (NPI 1184176950)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184176950 NPI number — SLEEP WELL, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SLEEP WELL, 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:
1184176950
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/17/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 STATE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BANGOR
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04401-5527
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-992-2660
Provider Business Mailing Address Fax Number:
207-992-2661

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
232 CENTER ST FL 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04210-6136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-344-1580
Provider Business Practice Location Address Fax Number:
207-992-2661
Provider Enumeration Date:
10/27/2016

Additional Information

Authorized Official

Authorized Official Last Name:
SARGENT
Authorized Official First Name:
NOAH
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
207-992-2660

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 409180000 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com