Provider Demographics
NPI:1629173109
Name:SLEEPCARE INSTITUTE, INC.
Entity Type:Organization
Organization Name:SLEEPCARE INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEVERLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-507-8344
Mailing Address - Street 1:1215 EAGLES LANDING PKWY
Mailing Address - Street 2:SUITE 209
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-7279
Mailing Address - Country:US
Mailing Address - Phone:770-507-8344
Mailing Address - Fax:770-507-1447
Practice Address - Street 1:1215 EAGLES LANDING PKWY
Practice Address - Street 2:SUITE 209
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7279
Practice Address - Country:US
Practice Address - Phone:770-507-8344
Practice Address - Fax:770-507-1447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA47BBBMPMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER