Provider Demographics
NPI:1669812574
Name:PALADIN SLEEP SERVICES LLC
Entity Type:Organization
Organization Name:PALADIN SLEEP SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:RPSGT
Authorized Official - Phone:912-674-1068
Mailing Address - Street 1:5420 NEW JESUP HWY
Mailing Address - Street 2:#50
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31523-1137
Mailing Address - Country:US
Mailing Address - Phone:912-674-1068
Mailing Address - Fax:
Practice Address - Street 1:167 HIGHLAND PARK CIR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31523-1161
Practice Address - Country:US
Practice Address - Phone:912-674-1068
Practice Address - Fax:912-289-2912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic