Provider Demographics
NPI:1043433170
Name:EMERALD SLEEP DISORDERS CENTER, LLC
Entity Type:Organization
Organization Name:EMERALD SLEEP DISORDERS CENTER, LLC
Other - Org Name:FLORENCE SLEEP DISORDERS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAINIS
Authorized Official - Middle Name:
Authorized Official - Last Name:IRBE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-683-3325
Mailing Address - Street 1:4725 VILLAGE PLAZA LOOP
Mailing Address - Street 2:SUITE 101
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-6677
Mailing Address - Country:US
Mailing Address - Phone:541-683-3325
Mailing Address - Fax:541-343-4117
Practice Address - Street 1:1525 12TH ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:OR
Practice Address - Zip Code:97439-9497
Practice Address - Country:US
Practice Address - Phone:541-902-7604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR107232Medicare ID - Type UnspecifiedGROUP