Healthcare Provider Details

I. General information

NPI: 1215102546
Provider Name (Legal Business Name): PREMIER SLEEP SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2008
Last Update Date: 02/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1928 RANDOLPH RD SUITE 111
CHARLOTTE NC
28207-1105
US

IV. Provider business mailing address

PO BOX 20048
CHARLESTON WV
25362-1048
US

V. Phone/Fax

Practice location:
  • Phone: 704-688-0803
  • Fax: 704-333-0115
Mailing address:
  • Phone: 304-720-1981
  • Fax: 304-720-1874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOHN E. BARGER III
Title or Position: VICE PRESIDENT
Credential:
Phone: 800-486-2620