Provider Demographics
NPI:1508499286
Name:NATIONS SLEEP DISORDERS CENTER OF NORTH CAROLINA LLC
Entity Type:Organization
Organization Name:NATIONS SLEEP DISORDERS CENTER OF NORTH CAROLINA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:NOLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-363-9250
Mailing Address - Street 1:463 POOLER PKWY # 163
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-5102
Mailing Address - Country:US
Mailing Address - Phone:478-363-9250
Mailing Address - Fax:
Practice Address - Street 1:658 N SPENCE AVE
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-4233
Practice Address - Country:US
Practice Address - Phone:478-363-9250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-20
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty