Provider Demographics
NPI:1093901837
Name:PREMIER SLEEP DIAGNOSTIC CENTERS II, LLC
Entity Type:Organization
Organization Name:PREMIER SLEEP DIAGNOSTIC CENTERS II, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:POTEET
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:423-877-9244
Mailing Address - Street 1:1603 HAMILL RD
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-4902
Mailing Address - Country:US
Mailing Address - Phone:423-877-9244
Mailing Address - Fax:423-877-9255
Practice Address - Street 1:7405 SHALLOWFORD RD STE 240
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2662
Practice Address - Country:US
Practice Address - Phone:423-648-1074
Practice Address - Fax:423-648-1078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-14
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic