Provider Demographics
NPI:1073702494
Name:LIFELINE SLEEP CENTER LLC
Entity Type:Organization
Organization Name:LIFELINE SLEEP CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:KEGG
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:412-351-6545
Mailing Address - Street 1:2030 ARDMORE BLVD
Mailing Address - Street 2:251
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221
Mailing Address - Country:US
Mailing Address - Phone:412-351-6545
Mailing Address - Fax:412-351-6547
Practice Address - Street 1:2030 ARDMORE BLVD
Practice Address - Street 2:251
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-4652
Practice Address - Country:US
Practice Address - Phone:412-351-6545
Practice Address - Fax:412-351-6547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAYM002985L332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies