Provider Demographics
NPI:1861536153
Name:SLEEP UNLIMITED CORINTH LAB LLC
Entity type:Organization
Organization Name:SLEEP UNLIMITED CORINTH LAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONT
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:EALY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-284-9502
Mailing Address - Street 1:2429 PROPER ST
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-5394
Mailing Address - Country:US
Mailing Address - Phone:662-284-9502
Mailing Address - Fax:662-284-9610
Practice Address - Street 1:2429 PROPER ST
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-5394
Practice Address - Country:US
Practice Address - Phone:662-284-9502
Practice Address - Fax:662-284-9610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic