Organization Name: | PREMIER SLEEP CENTER, LLC |
NPI Number: | 1770922866 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID BAXTER (PRESIDENT) |
Mailing Address: | 83 Crye Leike Dr Fort Oglethorpe |
State: | GA US |
Postal Code: | 307424055 |
Phone Number: | 9316984309 |
Fax Number: | |
NPI Enumeration Date: | 06/21/2013 |
NPI Last Update Date: | 06/21/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QS1200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Sleep Disorder Diagnostic |
Taxonomy Definition: |