1295021814 NPI number — SLEEPOX, LLC

Table of content: (NPI 1295021814)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295021814 NPI number — SLEEPOX, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SLEEPOX, 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:
1295021814
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/12/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 941960
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAITLAND
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32794-1960
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-728-2788
Provider Business Mailing Address Fax Number:
866-991-0388

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1720 KALISTE SALOOM ROAD
Provider Second Line Business Practice Location Address:
SUITE A-6
Provider Business Practice Location Address City Name:
LAFAYETTE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-728-2788
Provider Business Practice Location Address Fax Number:
866-991-0388
Provider Enumeration Date:
06/22/2011

Additional Information

Authorized Official

Authorized Official Last Name:
WRIGHT
Authorized Official First Name:
CAROLINE
Authorized Official Middle Name:
W
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
800-728-2788

Provider Taxonomy Codes

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

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

  • Identifier: 01533351 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2173731 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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