Provider Demographics
NPI:1477605202
Name:ADVANCED SLEEP TECH OF GA
Entity Type:Organization
Organization Name:ADVANCED SLEEP TECH OF GA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS RECEIVABLE
Authorized Official - Prefix:
Authorized Official - First Name:CHAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-376-4760
Mailing Address - Street 1:5 FINCH TRL NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2418
Mailing Address - Country:US
Mailing Address - Phone:404-376-4760
Mailing Address - Fax:
Practice Address - Street 1:5 FINCH TRL NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2418
Practice Address - Country:US
Practice Address - Phone:404-376-4760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory