1609831148 NPI number — CENTER FOR CARDIAC SLEEP MEDICINE LLC

Table of content: (NPI 1609831148)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609831148 NPI number — CENTER FOR CARDIAC SLEEP MEDICINE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTER FOR CARDIAC SLEEP MEDICINE 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:
1609831148
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/07/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10720 SIKES PL
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28277-8141
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-815-7789
Provider Business Mailing Address Fax Number:
888-401-6931

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
64040 HIGHWAY 434
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
LACOMBE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70445-3456
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-882-9200
Provider Business Practice Location Address Fax Number:
985-882-9090
Provider Enumeration Date:
04/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GUIDRY
Authorized Official First Name:
GARY
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
704-815-7804

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: P00350498 . This is a "RR MEDICARE" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




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