Provider Demographics
NPI:1366277873
Name:SERENITY CPAP CENTER LLC
Entity type:Organization
Organization Name:SERENITY CPAP CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARMAINE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:SMITH-GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-767-9583
Mailing Address - Street 1:7617 POCOSHOCK WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-6482
Mailing Address - Country:US
Mailing Address - Phone:804-767-9583
Mailing Address - Fax:
Practice Address - Street 1:7617 POCOSHOCK WAY
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-6482
Practice Address - Country:US
Practice Address - Phone:804-767-9583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies