Provider Demographics
NPI:1104120542
Name:SLEEP UNLIMITED CLARKSVILLE
Entity type:Organization
Organization Name:SLEEP UNLIMITED CLARKSVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:EALY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-758-2838
Mailing Address - Street 1:764 WALNUT KNOLL LN
Mailing Address - Street 2:STE 200
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-3113
Mailing Address - Country:US
Mailing Address - Phone:901-758-2838
Mailing Address - Fax:901-758-2479
Practice Address - Street 1:124 DUNBAR CAVE RD
Practice Address - Street 2:STE D
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-5700
Practice Address - Country:US
Practice Address - Phone:931-802-5285
Practice Address - Fax:931-802-5286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic