Provider Demographics
NPI:1093217085
Name:SLEEP GROUP SOUTH INC
Entity type:Organization
Organization Name:SLEEP GROUP SOUTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VERNON
Authorized Official - Middle Name:W
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:470-705-0788
Mailing Address - Street 1:1229 EAGLES LANDING PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-5114
Mailing Address - Country:US
Mailing Address - Phone:470-705-0788
Mailing Address - Fax:470-203-2094
Practice Address - Street 1:1229 EAGLES LANDING PKWY STE A
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-5114
Practice Address - Country:US
Practice Address - Phone:470-705-0788
Practice Address - Fax:470-203-2094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-06
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1223G0001X
GA8312332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty