Organization
JOHNSTON SLEEP DISORDERS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LINDSEY ELLIOT DEGUEHERY MD (MEDICAL DIRECTOR)
(919) 202-0023
Entity
Organization
Contact information
Practice address
115 E OAK ST, SELMA, NC 27576-2845
(919) 202-0023
(919) 202-0010
Mailing address
PO BOX 3997, WILSON, NC 27895-3997
(919) 202-0023
(919) 202-0010
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
246Z00000X
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015M7
BCBS OF NC
NC
05
—
89015M7
—
NC
01
—
P00247505
MEDICARE RAILROAD NUMBER
NC
Enumeration date
06/07/2006
Last updated
11/30/2007
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