Provider Demographics
NPI:1558394189
Name:SNOOZE RITE MEDICAL
Entity Type:Organization
Organization Name:SNOOZE RITE MEDICAL
Other - Org Name:SR MEDICAL
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:GIPSON
Authorized Official - Suffix:
Authorized Official - Credentials:RPSGT
Authorized Official - Phone:972-672-2546
Mailing Address - Street 1:3600 LEEDS CT
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:TX
Mailing Address - Zip Code:76210-4158
Mailing Address - Country:US
Mailing Address - Phone:972-672-2546
Mailing Address - Fax:
Practice Address - Street 1:4510 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1650
Practice Address - Country:US
Practice Address - Phone:972-672-2546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5693360001Medicare NSC