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NPI 1679917793

NPI 1679917793 : TOTAL SLEEP CARE : VIENNA, VA

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General NPI Number Information
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    NPI Number           |    1679917793
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    Entity Type          |    Organization 
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    Legal Business Name  |    TOTAL SLEEP CARE 
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Dates
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    Enumeration Date     |    04/19/2013
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    Last Update Date     |    02/19/2014
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Provider Practice Location Address
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    Address Line         |    226 MAPLE AVE W STE 311
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    City                 |    VIENNA
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    State                |    VA
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    Zip                  |    22180-5677
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    Country              |    US
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    Telephone            |    410-885-4411
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    Fax                  |    410-885-4409
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1457 
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    City                 |    VIENNA
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    State                |    VA
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    Zip                  |    22183-1457
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    Country              |    US
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    Telephone            |    410-885-4411
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    Fax                  |    410-885-4409
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     DANNIE  AHN 
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    Credential           |    
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    Telephone            |    410-885-4411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    291U00000X
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    Taxonomy Name        |    Clinical Medical Laboratory
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    332B00000X
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    Taxonomy Name        |    Durable Medical Equipment & Medical Supplies
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    261QS1200X
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    Taxonomy Name        |    Sleep Disorder Diagnostic Clinic/Center
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    License Number       |    
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    License Number State |    
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