Provider Demographics
NPI:1538594858
Name:PREMIER SLEEP SOLUTIONS
Entity type:Organization
Organization Name:PREMIER SLEEP SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAD
Authorized Official - Middle Name:LONDON
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:435-531-6595
Mailing Address - Street 1:1601 DOVE STREET
Mailing Address - Street 2:SUITE 175
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660
Mailing Address - Country:US
Mailing Address - Phone:949-396-6636
Mailing Address - Fax:435-674-2600
Practice Address - Street 1:1601 DOVE STREET
Practice Address - Street 2:SUITE 175
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660
Practice Address - Country:US
Practice Address - Phone:949-396-6636
Practice Address - Fax:435-674-2600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-05
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7231350001Medicare NSC