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General NPI Number Information
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NPI Number | 1922770379
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Entity Type | Organization
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Legal Business Name | SLEEP CARE CLINIC LLC
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Dates
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Enumeration Date | 10/04/2021
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Last Update Date | 04/08/2022
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Provider Practice Location Address
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Address Line | 7600 FERN AVE STE 700A
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City | SHREVEPORT
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State | LA
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Zip | 71105-5673
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Country | US
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Telephone | 318-657-0187
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Fax | 509-426-2160
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Provider Business Mailing Address
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Address Line | 7600 FERN AVE STE 700A
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City | SHREVEPORT
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State | LA
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Zip | 71105-5673
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Country | US
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Telephone | 318-657-0187
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Fax | 318-404-1510
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Authorized Official
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Title or Position | BILLING AND CREDENTIALING
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Name | BRENDA ROBERTS
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Credential |
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Telephone | 318-381-4759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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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