1194169284 NPI number — BEAR SLEEP CENTER LLC

Table of content: DR. PATRICK BYRNE HOLMES D.D.S., M.S.D. (NPI 1275969198)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194169284 NPI number — BEAR SLEEP CENTER LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEAR SLEEP CENTER 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:
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:
1194169284
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/19/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2005 OLD GREENBRIER RD
Provider Second Line Business Mailing Address:
SUITE NUMBER 106
Provider Business Mailing Address City Name:
CHESAPEAKE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23320-2649
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-962-8538
Provider Business Mailing Address Fax Number:
757-962-8598

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2005 OLD GREENBRIER RD
Provider Second Line Business Practice Location Address:
SUITE NUMBER 106
Provider Business Practice Location Address City Name:
CHESAPEAKE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23320-2649
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-962-8538
Provider Business Practice Location Address Fax Number:
757-962-8598
Provider Enumeration Date:
04/19/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CRUM
Authorized Official First Name:
KEVIN
Authorized Official Middle Name:
RAY
Authorized Official Title or Position:
COO/MANAGING OWNER
Authorized Official Telephone Number:
757-675-6400

Provider Taxonomy Codes

  • Taxonomy code: 261QS1200X , with the licence number:  03378 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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