1497784201 NPI number — SLEEP DIAGNOSTICS INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497784201 NPI number — SLEEP DIAGNOSTICS INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SLEEP DIAGNOSTICS 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:
QUALITY SLEEP
Provider Other Organization Name Type Code:
4
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:
1497784201
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/01/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2800 YOUREE DR
Provider Second Line Business Mailing Address:
SUITE 110
Provider Business Mailing Address City Name:
SHREVEPORT
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71104-3661
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-861-7533
Provider Business Mailing Address Fax Number:
318-861-7534

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2800 YOUREE DR
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
SHREVEPORT
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71104-3661
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-861-7533
Provider Business Practice Location Address Fax Number:
318-861-7534
Provider Enumeration Date:
07/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PROCELL
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
STEVEN
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
318-861-7533

Provider Taxonomy Codes

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

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





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