Provider Demographics
NPI:1164655668
Name:EZ SLEEP LAB,LLC
Entity Type:Organization
Organization Name:EZ SLEEP LAB,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SATTY
Authorized Official - Middle Name:
Authorized Official - Last Name:BHOWRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-550-4065
Mailing Address - Street 1:PO BOX 47090
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85068-7090
Mailing Address - Country:US
Mailing Address - Phone:602-550-4065
Mailing Address - Fax:623-934-5603
Practice Address - Street 1:401 S CALVARY WAY
Practice Address - Street 2:SUITE B
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-4165
Practice Address - Country:US
Practice Address - Phone:602-550-4065
Practice Address - Fax:623-934-5603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic