Healthcare Provider Details

I. General information

NPI: 1811963580
Provider Name (Legal Business Name): WINCHESTER SLEEP CENTER,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2230 COWAN HWY
WINCHESTER TN
37398-2627
US

IV. Provider business mailing address

2230 COWAN HWY
WINCHESTER TN
37398-2627
US

V. Phone/Fax

Practice location:
  • Phone: 931-962-3433
  • Fax: 931-962-3432
Mailing address:
  • Phone: 931-962-3433
  • Fax: 931-962-3432

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: MRS. MARILYN SMITH
Title or Position: OFFICE MANAGER
Credential: RN
Phone: 931-962-3433