Provider Demographics
NPI:1417270760
Name:PSS,LLC
Entity Type:Organization
Organization Name:PSS,LLC
Other - Org Name:PORTABLE SLEEP STUDIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-740-8602
Mailing Address - Street 1:7225 S 85TH EAST AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-3135
Mailing Address - Country:US
Mailing Address - Phone:918-740-8602
Mailing Address - Fax:918-461-0682
Practice Address - Street 1:7225 S 85TH EAST AVE STE 200
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-3135
Practice Address - Country:US
Practice Address - Phone:918-740-8602
Practice Address - Fax:918-461-0682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic