Healthcare Provider Details
I. General information
NPI: 1598922296
Provider Name (Legal Business Name): TOTAL SLEEP HOLDINGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/20/2008
Last Update Date: 07/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6630 MCGINNIS FERRY RD STE B
DULUTH GA
30097-1542
US
IV. Provider business mailing address
1000 HURRICANE SHOALS RD NE BLDG B, STE 800
LAWRENCEVILLE GA
30043-4826
US
V. Phone/Fax
- Phone: 770-237-8440
- Fax: 770-237-8680
- Phone: 770-237-8440
- Fax: 770-237-8680
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QS1200X |
| Taxonomy | Sleep Disorder Diagnostic Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILLIAM
J
GUIDETTI
Title or Position: CEO
Credential:
Phone: 469-499-2857