Provider Demographics
NPI:1700233541
Name:SALTERBECK SLEEP LLC
Entity Type:Organization
Organization Name:SALTERBECK SLEEP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL OFFICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNESHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-771-0220
Mailing Address - Street 1:768 TRAVELERS BLVD
Mailing Address - Street 2:102
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-8940
Mailing Address - Country:US
Mailing Address - Phone:843-771-0220
Mailing Address - Fax:843-376-7989
Practice Address - Street 1:3400 SALTERBECK CT
Practice Address - Street 2:100B
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-7118
Practice Address - Country:US
Practice Address - Phone:843-771-0220
Practice Address - Fax:843-376-7989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20048054293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory