Provider Demographics
NPI: | 1386372506 |
---|---|
Name: | SLEEP WELL EAST TENNESSEE PPLC |
Entity type: | Organization |
Organization Name: | SLEEP WELL EAST TENNESSEE PPLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | CHRISTOPHER |
Authorized Official - Middle Name: | DAVID |
Authorized Official - Last Name: | LEE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 865-617-6001 |
Mailing Address - Street 1: | 10629 HARDIN VALLEY RD # 134 |
Mailing Address - Street 2: | |
Mailing Address - City: | KNOXVILLE |
Mailing Address - State: | TN |
Mailing Address - Zip Code: | 37932-1504 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 201 BUS TERMINAL RD STE 100 |
Practice Address - Street 2: | |
Practice Address - City: | OAK RIDGE |
Practice Address - State: | TN |
Practice Address - Zip Code: | 37830-6903 |
Practice Address - Country: | US |
Practice Address - Phone: | 865-617-6001 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2022-08-15 |
Last Update Date: | 2023-06-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 332BC3200X | Suppliers | Durable Medical Equipment & Medical Supplies | Customized Equipment | |
No | 122300000X | Dental Providers | Dentist | Group - Multi-Specialty |