MEDICARE: SLEEP AND LUNG HEALTH CENTER, PLLC

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	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number	:	1356608681
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLEEP AND LUNG HEALTH CENTER, PLLC

Provider Business Mailing Address
First Line	:	8066 WALNUT RUN RD
Second Line	:	SUITE 205
City	:	CORDOVA
State	:	TN
Zip	:	38018-8841
Country	:	US
Telephone Number	:	901-405-1005
Fax Number	:	901-255-2606

Provider Business Practice Location Address
First Line	:	8066 WALNUT RUN RD
Second Line	:	SUITE 205
City	:	CORDOVA
State	:	TN
Zip	:	38018-8841
Country	:	US
Telephone Number	:	901-405-1005
Fax Number	:	901-255-2606

Authorized Official
Title or Position	:	MANAGER
Name	:	MISS MEGAN LYN WILLIAMSON
Credential	:	RPSGT
Telephone Number	:	901-405-1005

Provider Enumeration Date	:	04/11/2012
Last Update Date	:	04/11/2012

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