Provider Demographics
NPI:1689748436
Name:PREMIER SLEEP LLC
Entity Type:Organization
Organization Name:PREMIER SLEEP LLC
Other - Org Name:PREMIER SLEEP DISORDERS CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:PFISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-572-9654
Mailing Address - Street 1:111 NORTHPARK DR
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-2924
Mailing Address - Country:US
Mailing Address - Phone:361-572-9654
Mailing Address - Fax:361-485-2233
Practice Address - Street 1:111 NORTHPARK DR
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-2924
Practice Address - Country:US
Practice Address - Phone:361-572-9654
Practice Address - Fax:361-485-2233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX530785OtherBCBS DME PROVIDER #
TX7094171OtherAETNA PROVIDER#