Healthcare Provider Details

I. General information

NPI: 1700067972
Provider Name (Legal Business Name): ATLANTIC SLEEP CENTERS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2007
Last Update Date: 08/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7211 OGDEN BUSINESS LN SUITE 201
WILMINGTON NC
28411-5300
US

IV. Provider business mailing address

7211 OGDEN BUSINESS LN SUITE 201
WILMINGTON NC
28411-5300
US

V. Phone/Fax

Practice location:
  • Phone: 910-371-1777
  • Fax: 866-302-4209
Mailing address:
  • Phone: 910-371-1777
  • Fax: 866-302-4209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number9401205
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number02123
License Number StateNC

VIII. Authorized Official

Name: JAMES J PENCE JR.
Title or Position: OWNER
Credential: M.D.
Phone: 910-622-4983