Healthcare Provider Details

I. General information

NPI: 1225620883
Provider Name (Legal Business Name): SLEEP & SNORING CPAP ALTERNATIVES ARIZONA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2021
Last Update Date: 11/05/2021
Certification Date: 11/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 E UNIVERSITY DR STE 12
MESA AZ
85203-8046
US

IV. Provider business mailing address

1050 E UNIVERSITY DR STE 12
MESA AZ
85203-8046
US

V. Phone/Fax

Practice location:
  • Phone: 480-742-9425
  • Fax: 602-671-0663
Mailing address:
  • Phone: 480-742-9425
  • Fax: 602-671-0663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LORENA MOORHEAD
Title or Position: OWNER
Credential:
Phone: 480-586-6101