Provider Demographics
NPI:1265452049
Name:O2 SLEEP, INC.
Entity Type:Organization
Organization Name:O2 SLEEP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:GUTKNECHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-553-1909
Mailing Address - Street 1:PO BOX 482
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38088-0482
Mailing Address - Country:US
Mailing Address - Phone:901-526-0202
Mailing Address - Fax:901-526-0300
Practice Address - Street 1:5042 THOROUGHBRED LN
Practice Address - Street 2:SUITE A
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-4232
Practice Address - Country:US
Practice Address - Phone:615-377-9892
Practice Address - Fax:615-377-3212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN888332B00000X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1455110Medicaid
TN5748620001Medicare NSC