1558545400 NPI number — SLEEP TELEMEDICINE SERCIVES 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 1558545400 NPI number — SLEEP TELEMEDICINE SERCIVES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SLEEP TELEMEDICINE SERCIVES 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:
1558545400
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/27/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
908 W TERRELL AVE N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT WORTH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76104-3034
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-820-0427
Provider Business Mailing Address Fax Number:
817-820-0430

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1400 SWEET HOME RD STE 5
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AMHERST
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14228-2777
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-691-6283
Provider Business Practice Location Address Fax Number:
716-691-6314
Provider Enumeration Date:
12/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
ANN
Authorized Official Middle Name:
Authorized Official Title or Position:
VP
Authorized Official Telephone Number:
817-820-0427

Provider Taxonomy Codes

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

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





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