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General NPI Number Information
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NPI Number | 1821362351
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Entity Type | Organization
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Legal Business Name | LUXURY SLEEP, LLC
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Dates
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Enumeration Date | 03/01/2012
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Last Update Date | 03/01/2012
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Provider Practice Location Address
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Address Line | 1833 PEACHTREE RD NE
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City | ATLANTA
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State | GA
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Zip | 30309-1524
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Country | US
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Telephone | 404-748-1927
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Fax | 404-748-9513
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Provider Business Mailing Address
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Address Line | 1833 PEACHTREE RD NE
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City | ATLANTA
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State | GA
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Zip | 30309-1524
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Country | US
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Telephone | 404-748-1927
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Fax | 404-748-9513
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Authorized Official
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Title or Position | CEO
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Name | MISS MALINDA WALLER
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Credential | B.S. IN BIOLOGY
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Telephone | 404-748-1927
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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 | 11086172
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License Number State | GA
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