Provider Demographics
NPI:1295822724
Name:MOBILE SLEEP DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:MOBILE SLEEP DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:CORBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-255-1554
Mailing Address - Street 1:2232 N 7TH ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-7459
Mailing Address - Country:US
Mailing Address - Phone:970-255-1554
Mailing Address - Fax:970-257-1301
Practice Address - Street 1:2232 N 7TH ST
Practice Address - Street 2:SUITE 3
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-7459
Practice Address - Country:US
Practice Address - Phone:970-255-1554
Practice Address - Fax:970-257-1301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO464618Medicare ID - Type UnspecifiedPROVIDER ID NUMBER