Organization
JOHNSTON SLEEP DISORDERS CENTER LLC
Active
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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