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General NPI Number Information
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NPI Number | 1851833933
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Entity Type | Organization
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Legal Business Name | RENEW SLEEP SOLUTIONS, INC.
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Dates
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Enumeration Date | 11/07/2016
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Last Update Date | 01/06/2017
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Provider Practice Location Address
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Address Line | 5018 E 68TH ST
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City | TULSA
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State | OK
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Zip | 74136-3367
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Country | US
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Telephone | 918-281-2001
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Fax | 855-480-9542
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Provider Business Mailing Address
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Address Line | 1050 TEXAN TRL SUITE 300
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City | GRAPEVINE
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State | TX
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Zip | 76051-3741
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Country | US
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Telephone | 469-778-6100
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Fax | 866-300-4682
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Authorized Official
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Title or Position | CEO
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Name | JAMES R EVANGER
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Credential |
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Telephone | 904-469-3119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 6410
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License Number State | OK
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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 | OK
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