Provider Demographics
| NPI: | 1710138805 |
|---|---|
| Name: | SWEET DREAMS OF ALBANY LLC |
| Entity type: | Organization |
| Organization Name: | SWEET DREAMS OF ALBANY LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | PRESIDENT |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | JARED |
| Authorized Official - Middle Name: | B |
| Authorized Official - Last Name: | DERANEY |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | CRNA |
| Authorized Official - Phone: | 888-728-0882 |
| Mailing Address - Street 1: | PO BOX 850001 DEPT 740Q |
| Mailing Address - Street 2: | |
| Mailing Address - City: | ORLANDO |
| Mailing Address - State: | FL |
| Mailing Address - Zip Code: | 32885-4380 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 941-360-1566 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 4080 MCGINNIS FERRY RD STE 102 |
| Practice Address - Street 2: | |
| Practice Address - City: | ALPHARETTA |
| Practice Address - State: | GA |
| Practice Address - Zip Code: | 30005-3901 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 888-728-0882 |
| Practice Address - Fax: | 888-512-1507 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2008-10-07 |
| Last Update Date: | 2020-05-07 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 367500000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | Group - Single Specialty |