1366697484 NPI number — SLEEP SOLUTIONS OF THE WESTBANK

Table of content: (NPI 1366697484)

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: 261QS1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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