Provider Demographics
NPI:1205609245
Name:SLEEP REMEDIES, LLC
Entity type:Organization
Organization Name:SLEEP REMEDIES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MALLORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:NYENHUIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:920-918-0843
Mailing Address - Street 1:2756 W HIGHLAND MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMS
Mailing Address - State:AZ
Mailing Address - Zip Code:86046-9179
Mailing Address - Country:US
Mailing Address - Phone:920-918-0843
Mailing Address - Fax:
Practice Address - Street 1:223 N SAN FRANCISCO ST STE 104
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-4657
Practice Address - Country:US
Practice Address - Phone:928-275-1252
Practice Address - Fax:855-750-7010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-01
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No122300000XDental ProvidersDentistGroup - Multi-Specialty