Basic Information
| Provider Information | |||||||||
| NPI: | 1578816716 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | COSTRINI SLEEP SERVICES, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | GOOD SLEEP | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11909 MCAULEY DRIVE | ||||||||
| Address2: | PLAZA C, SUITE A-1 | ||||||||
| City: | SAVANNAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 31419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9129276680 | ||||||||
| FaxNumber: | 9129270062 | ||||||||
| Practice Location | |||||||||
| Address1: | 8 OKATIE CENTER BLVD., SOUTH | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | BLUFFTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29909 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9129276680 | ||||||||
| FaxNumber: | 9129270062 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2012 | ||||||||
| LastUpdateDate: | 11/28/2018 | ||||||||
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| AuthorizedOfficialLastName: | MORGAN | ||||||||
| AuthorizedOfficialFirstName: | MELANIE | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9129276680 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | COSTRINI SLEEP SERVICES, INC. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RS0012X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | 207RP1001X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.