1881751618 NPI number — SLEEP EZ LLC

Table of content: (NPI 1881751618)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881751618 NPI number — SLEEP EZ LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SLEEP EZ 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:
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:
1881751618
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 245
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38402
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
931-840-5425
Provider Business Mailing Address Fax Number:
931-840-6287

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
502 NORTH GARDEN
Provider Second Line Business Practice Location Address:
STE 107
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
931-840-5425
Provider Business Practice Location Address Fax Number:
931-840-6287
Provider Enumeration Date:
01/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FLOYD
Authorized Official First Name:
MICHELLE
Authorized Official Middle Name:
RENEE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
931-840-5425

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)

  • Identifier: 3149082 . This is a "BCBS" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 3790564 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".




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