Provider Demographics
NPI:1851833933
Name:RENEW SLEEP SOLUTIONS, INC.
Entity Type:Organization
Organization Name:RENEW SLEEP SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:EVANGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-469-3119
Mailing Address - Street 1:1050 TEXAN TRL
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-3741
Mailing Address - Country:US
Mailing Address - Phone:469-778-6100
Mailing Address - Fax:866-300-4682
Practice Address - Street 1:5018 E 68TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-3367
Practice Address - Country:US
Practice Address - Phone:918-281-2001
Practice Address - Fax:855-480-9542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK64101223G0001X
OK332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty