Provider Demographics
NPI:1073566535
Name:AMERICAN SLEEP DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:AMERICAN SLEEP DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SHUFELDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-251-7300
Mailing Address - Street 1:1411 W 4TH ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:COFFEYVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:67337-3300
Mailing Address - Country:US
Mailing Address - Phone:620-251-7300
Mailing Address - Fax:620-251-7301
Practice Address - Street 1:1411 W 4TH ST
Practice Address - Street 2:SUITE F
Practice Address - City:COFFEYVILLE
Practice Address - State:KS
Practice Address - Zip Code:67337-3300
Practice Address - Country:US
Practice Address - Phone:620-251-7300
Practice Address - Fax:620-251-7301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS118359OtherBCBS OF KANSAS PROV NUMBE
KS130645Medicare ID - Type UnspecifiedPROVIDER NUMBER