Provider Demographics
NPI:1700076890
Name:ALBEMARLE SLEEP DISORDERS
Entity Type:Organization
Organization Name:ALBEMARLE SLEEP DISORDERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/TECH
Authorized Official - Prefix:
Authorized Official - First Name:SUMMER
Authorized Official - Middle Name:L
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-312-4247
Mailing Address - Street 1:118 DANIELLE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909
Mailing Address - Country:US
Mailing Address - Phone:252-264-3890
Mailing Address - Fax:
Practice Address - Street 1:118 DANIELLE DRIVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909
Practice Address - Country:US
Practice Address - Phone:252-264-3890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic