Provider Demographics
NPI:1104195924
Name:JUNEAU SLEEP DIAGNOSTICS CENTER LLC
Entity Type:Organization
Organization Name:JUNEAU SLEEP DIAGNOSTICS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MORNINGSTAR
Authorized Official - Middle Name:U
Authorized Official - Last Name:SINCLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-957-6173
Mailing Address - Street 1:8439 VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-9151
Mailing Address - Country:US
Mailing Address - Phone:907-957-6173
Mailing Address - Fax:
Practice Address - Street 1:8439 VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-9151
Practice Address - Country:US
Practice Address - Phone:907-957-6173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-22
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic