Provider Demographics
NPI:1043631393
Name:PRO SLEEP TESTING
Entity Type:Organization
Organization Name:PRO SLEEP TESTING
Other - Org Name:PINNACLE HOME SLEEP TESTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GERGIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-680-4540
Mailing Address - Street 1:7757 W DEER VALLEY RD
Mailing Address - Street 2:STE 260
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-2118
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7757 W DEER VALLEY RD
Practice Address - Street 2:STE 260
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-2118
Practice Address - Country:US
Practice Address - Phone:602-680-4540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-03
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35331174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty