Provider Demographics
NPI:1306014212
Name:SLEEPWELL CENTER PROFESSIONAL LLC
Entity Type:Organization
Organization Name:SLEEPWELL CENTER PROFESSIONAL LLC
Other - Org Name:THE SLEEPWELL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ISRAEL
Authorized Official - Last Name:SLAMOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-200-4884
Mailing Address - Street 1:820 S MONACO PKWY
Mailing Address - Street 2:#355
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-3703
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5650 DTC PKWY
Practice Address - Street 2:SUITE 150
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-3003
Practice Address - Country:US
Practice Address - Phone:720-200-4884
Practice Address - Fax:720-200-5951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO36279358Medicaid
CO36279358Medicaid
CO5177320001Medicare NSC