Healthcare Provider Details

I. General information

NPI: 1477096584
Provider Name (Legal Business Name): AT HOME SLEEP TESTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2016
Last Update Date: 11/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 E WILLIAMS ST
APEX NC
27502-2151
US

IV. Provider business mailing address

1017 TENDER DR
APEX NC
27502-2405
US

V. Phone/Fax

Practice location:
  • Phone: 919-455-4407
  • Fax: 888-225-1980
Mailing address:
  • Phone: 919-455-4407
  • Fax: 888-225-1980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number7820
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. ROBERT GRANT
Title or Position: OWNER
Credential: RPSGT
Phone: 919-455-4407