MEDICARE: SLEEP REMEDY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry
2	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1124743695
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLEEP REMEDY LLC

Provider Business Mailing Address
First Line	:	923 KIRBY ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-5439
Country	:	US
Telephone Number	:	337-540-7001
Fax Number	:

Provider Business Practice Location Address
First Line	:	715 W COLLEGE ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70605-1523
Country	:	US
Telephone Number	:	337-478-3123
Fax Number	:	337-504-7875

Authorized Official
Title or Position	:	OWNER
Name	:	DR. STEPHANIE WEAVER
Credential	:	DDS
Telephone Number	:	337-540-7001

Provider Enumeration Date	:	10/07/2022
Last Update Date	:	02/06/2023

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Directions to “SLEEP REMEDY LLC ” Practice Location

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