Provider Demographics
NPI:1497922009
Name:NORTH ALABAMA SLEEP DISORDER CENTER, LLC
Entity Type:Organization
Organization Name:NORTH ALABAMA SLEEP DISORDER CENTER, LLC
Other - Org Name:NORTH AL SLEEP DISORDER CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CCO
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-386-4005
Mailing Address - Street 1:PO BOX 627
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35660-0627
Mailing Address - Country:US
Mailing Address - Phone:256-386-4005
Mailing Address - Fax:256-386-4685
Practice Address - Street 1:1111 S RALEIGH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SHEFFIELD
Practice Address - State:AL
Practice Address - Zip Code:35660-6350
Practice Address - Country:US
Practice Address - Phone:256-386-4005
Practice Address - Fax:256-386-4685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11784261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051550480OtherMEDICARE IDTF