Provider Demographics
NPI:1669708608
Name:SLEEP EZ OF JACKSONVILLE INC.
Entity type:Organization
Organization Name:SLEEP EZ OF JACKSONVILLE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:E
Authorized Official - Last Name:HALE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:904-886-4611
Mailing Address - Street 1:6735 GREENLAND INDUSTRIAL BLVD.
Mailing Address - Street 2:BLDG 100
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258
Mailing Address - Country:US
Mailing Address - Phone:904-886-4611
Mailing Address - Fax:904-880-7674
Practice Address - Street 1:6735 GREENLAND INDUSTRIAL BLVD.
Practice Address - Street 2:BLDG 100
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258
Practice Address - Country:US
Practice Address - Phone:904-886-4611
Practice Address - Fax:904-880-7674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC8569293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory