Provider Demographics
NPI:1629303516
Name:SLEEP SOLUTIONS OF UPTOWN
Entity type:Organization
Organization Name:SLEEP SOLUTIONS OF UPTOWN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER / DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:LAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-875-7557
Mailing Address - Street 1:PO BOX 699
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70447
Mailing Address - Country:US
Mailing Address - Phone:985-875-7557
Mailing Address - Fax:985-875-0595
Practice Address - Street 1:1328 ALINE ST.
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115
Practice Address - Country:US
Practice Address - Phone:504-598-6370
Practice Address - Fax:504-598-6371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-09
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5DA71Medicare UPIN