Healthcare Provider Details

I. General information

NPI: 1891457693
Provider Name (Legal Business Name): SLEEP SOLUTIONS OF ALABAMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2021
Last Update Date: 10/08/2021
Certification Date: 10/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1306 14TH AVE SE
DECATUR AL
35601-4346
US

IV. Provider business mailing address

1306 14TH AVE SE
DECATUR AL
35601-4346
US

V. Phone/Fax

Practice location:
  • Phone: 205-563-4162
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOSH DRAKE
Title or Position: OWNER
Credential: DMD
Phone: 205-563-4162