Provider Demographics
NPI:1528280021
Name:THE CENTER FOR PULMONARY & SLEEP DISORDERS,PLLC
Entity type:Organization
Organization Name:THE CENTER FOR PULMONARY & SLEEP DISORDERS,PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WINFRED
Authorized Official - Middle Name:C
Authorized Official - Last Name:MANDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD,FCCP
Authorized Official - Phone:423-553-1155
Mailing Address - Street 1:1949 GUNBARREL RD
Mailing Address - Street 2:SUITE#230
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3188
Mailing Address - Country:US
Mailing Address - Phone:423-553-1155
Mailing Address - Fax:423-553-1124
Practice Address - Street 1:1949 GUNBARREL RD
Practice Address - Street 2:SUITE#230
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3188
Practice Address - Country:US
Practice Address - Phone:423-553-1155
Practice Address - Fax:423-553-1124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38183174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNTN0101Medicaid
TNH75007Medicare UPIN
TNTN0101Medicaid