Provider Demographics
NPI:1336552819
Name:CHATTAHOOCHEE SLEEP CENTER DME, LLC
Entity Type:Organization
Organization Name:CHATTAHOOCHEE SLEEP CENTER DME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYANT
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-221-7196
Mailing Address - Street 1:2410 DOUBLE CHURCHES RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-2987
Mailing Address - Country:US
Mailing Address - Phone:706-221-7196
Mailing Address - Fax:706-221-7254
Practice Address - Street 1:2410 DOUBLE CHURCHES RD
Practice Address - Street 2:SUITE B
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-2987
Practice Address - Country:US
Practice Address - Phone:706-221-7196
Practice Address - Fax:706-221-7254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies