Provider Demographics
NPI:1134171341
Name:PAYSON SLEEP SERVICES, INC.
Entity type:Organization
Organization Name:PAYSON SLEEP SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MCGEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-474-5234
Mailing Address - Street 1:404 W MAIN ST
Mailing Address - Street 2:STE A
Mailing Address - City:PAYSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85541-5377
Mailing Address - Country:US
Mailing Address - Phone:928-474-5234
Mailing Address - Fax:928-474-5235
Practice Address - Street 1:404 W MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:PAYSON
Practice Address - State:AZ
Practice Address - Zip Code:85541-5377
Practice Address - Country:US
Practice Address - Phone:928-474-5234
Practice Address - Fax:928-474-5235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTC 4278261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZOTC 4278OtherDEPT OF HEALTH SVCS LICENSE
AZ352463Medicaid
AZ352463Medicaid