Organization
JESSIE R. PRUITT DBA SLEEP 2 GO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JESSIE RAYLENE PRUITT C.R.T. (OWNER)
(806) 322-0941
Entity
Organization
Contact information
Practice address
6652 CANYON DR STE 3, AMARILLO, TX 79109-7013
(806) 322-0941
Mailing address
6652 CANYON DR STE 3, AMARILLO, TX 79109-7013
(806) 322-0941
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1000557
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000557
TEXAS DEPARTMENT OF HEALTH DEVICE DISTRIBUTOR LICENSE
TX
Enumeration date
10/26/2011
Last updated
10/26/2011
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