Provider Demographics
NPI:1093901662
Name:HINESVILLE SLEEP DISORDERS CENTER
Entity Type:Organization
Organization Name:HINESVILLE SLEEP DISORDERS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAKE
Authorized Official - Middle Name:WALKER
Authorized Official - Last Name:DALY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-354-6614
Mailing Address - Street 1:340 EISENHOWER DR
Mailing Address - Street 2:BLDG. 1500
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-1600
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:447 W GENERAL SCREVEN WAY STE B
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-3075
Practice Address - Country:US
Practice Address - Phone:912-352-9049
Practice Address - Fax:912-352-8985
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RESPIRATORY CARE ENTERPRISES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory