Provider Demographics
NPI:1952587842
Name:SLEEPCARE INSTITUTE, INC.
Entity Type:Organization
Organization Name:SLEEPCARE INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEVERLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-507-8344
Mailing Address - Street 1:151 N PARK TRL
Mailing Address - Street 2:STE B
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-7373
Mailing Address - Country:US
Mailing Address - Phone:770-507-8344
Mailing Address - Fax:770-507-1447
Practice Address - Street 1:836 E 65TH ST
Practice Address - Street 2:BLDG 2
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4411
Practice Address - Country:US
Practice Address - Phone:912-691-0031
Practice Address - Fax:912-355-2360
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SLEEPCARE INSTITUTE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA47BBBQWMedicare PIN