Provider Demographics
NPI:1023243003
Name:E Z SLEEP LAB, LLC
Entity type:Organization
Organization Name:E Z SLEEP LAB, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SATTY
Authorized Official - Middle Name:
Authorized Official - Last Name:BHOWRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-550-4065
Mailing Address - Street 1:PO BOX 47090
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85068-7090
Mailing Address - Country:US
Mailing Address - Phone:602-550-4065
Mailing Address - Fax:623-934-5603
Practice Address - Street 1:14973 W BELL RD
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-3236
Practice Address - Country:US
Practice Address - Phone:602-550-4065
Practice Address - Fax:623-934-5603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-20
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTC 4137261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic