1699860346 NPI number — LUNG AND SLEEP SPECIALISTS, PLLC

Table of content: (NPI 1699860346)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699860346 NPI number — LUNG AND SLEEP SPECIALISTS, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LUNG AND SLEEP SPECIALISTS, PLLC
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:
1699860346
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/21/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 950173
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40295-0173
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-213-9036
Provider Business Mailing Address Fax Number:
502-412-9178

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1850 STATE ST
Provider Second Line Business Practice Location Address:
ATTN: SLEEP CLINIC
Provider Business Practice Location Address City Name:
NEW ALBANY
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47150-4990
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-949-5550
Provider Business Practice Location Address Fax Number:
812-949-5748
Provider Enumeration Date:
10/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DRAW
Authorized Official First Name:
AZMI
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
502-216-0191

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X , with the licence number:  36883 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RP1001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 200862900 A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 65945966 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com