1891922365 NPI number — SLEEP SOLUTIONS OF THIBODAUX

Table of content: (NPI 1891922365)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891922365 NPI number — SLEEP SOLUTIONS OF THIBODAUX

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SLEEP SOLUTIONS OF THIBODAUX
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:
1891922365
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/28/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. 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:
70447-0699
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:
2000 AUDUBON AVE
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
THIBODAUX
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70301-5075
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-446-0552
Provider Business Practice Location Address Fax Number:
985-447-1061
Provider Enumeration Date:
06/11/2009

Additional Information

Authorized Official

Authorized Official Last Name:
JUNIUS
Authorized Official First Name:
JO
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF BILLING & COLLECTIONS
Authorized Official Telephone Number:
985-875-7557

Provider Taxonomy Codes

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

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





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