Provider Demographics
NPI:1114441441
Name:ASD SLEEP LLC
Entity Type:Organization
Organization Name:ASD SLEEP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:N
Authorized Official - Last Name:GREGERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-555-1518
Mailing Address - Street 1:76 W. HARDING AVE
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-2562
Mailing Address - Country:US
Mailing Address - Phone:800-555-1518
Mailing Address - Fax:800-315-0481
Practice Address - Street 1:76 W. HARDING AVE
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-2562
Practice Address - Country:US
Practice Address - Phone:800-555-1518
Practice Address - Fax:800-315-0481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-28
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier