Provider Demographics
NPI:1841223872
Name:CU SLEEP CENTER LLC
Entity Type:Organization
Organization Name:CU SLEEP CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JIMMIE
Authorized Official - Middle Name:ROYCE
Authorized Official - Last Name:DAUGHERYT
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:423-764-4429
Mailing Address - Street 1:105 MEADOWVIEW RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-1725
Mailing Address - Country:US
Mailing Address - Phone:423-764-4429
Mailing Address - Fax:423-764-4486
Practice Address - Street 1:105 MEADOWVIEW RD
Practice Address - Street 2:SUITE 2
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-1725
Practice Address - Country:US
Practice Address - Phone:423-764-4429
Practice Address - Fax:423-764-4486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3791123Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER