Provider Demographics
NPI:1407976707
Name:BOWIE SLEEP AND WELLNESS
Entity Type:Organization
Organization Name:BOWIE SLEEP AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BETANCES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-464-9479
Mailing Address - Street 1:14999 HEALTH CENTER DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1074
Mailing Address - Country:US
Mailing Address - Phone:301-262-8188
Mailing Address - Fax:301-464-8233
Practice Address - Street 1:14999 HEALTH CENTER DR
Practice Address - Street 2:SUITE 201
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-1074
Practice Address - Country:US
Practice Address - Phone:301-262-8188
Practice Address - Fax:301-464-8233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD384452279P1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2279P1004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary DiagnosticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD=========OtherTAX ID