Provider Demographics
NPI:1285847905
Name:TOTAL SLEEP DIAGNOSITCS OF GEORGIA
Entity Type:Organization
Organization Name:TOTAL SLEEP DIAGNOSITCS OF GEORGIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AR DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BETSY
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-626-6211
Mailing Address - Street 1:4 SAINT ANN DR
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-3265
Mailing Address - Country:US
Mailing Address - Phone:985-626-6211
Mailing Address - Fax:985-626-6227
Practice Address - Street 1:1000 HURRICANE SHOALS RD NE BLDG B-800
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-4826
Practice Address - Country:US
Practice Address - Phone:770-237-8440
Practice Address - Fax:770-237-9268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2006018928247200000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies