# AVILYS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669888657
- **Authorized official:** MARK SHANE MOBLEY (PRESIDENT)
- **Authorized official phone:** (855) 228-4597

## Contact information

- **Practice address:** 2300 NORTHSIDE XING, STE B, MACON, GA 31210-2254
- **Practice address phone:** (855) 228-4597
- **Practice address fax:** (855) 428-4597
- **Mailing address:** 2300 NORTHSIDE XING, STE B, MACON, GA 31210-2254
- **Mailing address phone:** (855) 228-4597
- **Mailing address fax:** (855) 428-4597

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1200X | Sleep Disorder Diagnostic Clinic/Center | — | NULL | Yes |
| 293D00000X | Physiological Laboratory | — | NULL | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 07/10/2014
- **Last updated:** 02/02/2023