Healthcare Provider Details

I. General information

NPI: 1215176177
Provider Name (Legal Business Name): MAUMELLE SLEEP SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2009
Last Update Date: 03/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 MILLWOOD CIR SUITE F
MAUMELLE AR
72113-6327
US

IV. Provider business mailing address

9305 TREASURE HILL RD
LITTLE ROCK AR
72227-6217
US

V. Phone/Fax

Practice location:
  • Phone: 501-224-5200
  • Fax: 501-224-5208
Mailing address:
  • Phone: 501-224-5200
  • Fax: 501-224-5208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number StateAR

VIII. Authorized Official

Name: MR. WHITNEY BRENKE
Title or Position: OPERATIONS MANAGER
Credential: RRT,RPSGT
Phone: 501-224-5200