Provider Demographics
NPI:1194766071
Name:FUSION SLEEP THERAPY SERVICES
Entity type:Organization
Organization Name:FUSION SLEEP THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SIGURJON
Authorized Official - Middle Name:
Authorized Official - Last Name:KRISTJANSSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-990-3962
Mailing Address - Street 1:5000 RESEARCH COURT
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6660
Mailing Address - Country:US
Mailing Address - Phone:678-990-3962
Mailing Address - Fax:678-840-3777
Practice Address - Street 1:4245 JOHNS CREEK PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-9122
Practice Address - Country:US
Practice Address - Phone:678-990-3962
Practice Address - Fax:678-840-3777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5626250001Medicare NSC