Provider Demographics
NPI:1750482147
Name:TNERSLEEP LAB OF UNION CITY
Entity type:Organization
Organization Name:TNERSLEEP LAB OF UNION CITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-885-8666
Mailing Address - Street 1:126 E MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:UNION CITY
Mailing Address - State:TN
Mailing Address - Zip Code:38261-3349
Mailing Address - Country:US
Mailing Address - Phone:731-885-8666
Mailing Address - Fax:
Practice Address - Street 1:126 E MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-3349
Practice Address - Country:US
Practice Address - Phone:731-885-8666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14467291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory