Provider Demographics
NPI:1306863246
Name:SKAGGZZZ SLEEP INSTITUTE, INC.
Entity Type:Organization
Organization Name:SKAGGZZZ SLEEP INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:SKAGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-760-1501
Mailing Address - Street 1:1269 DOCTORS DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-2947
Mailing Address - Country:US
Mailing Address - Phone:573-760-1501
Mailing Address - Fax:573-760-1531
Practice Address - Street 1:1269 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-2947
Practice Address - Country:US
Practice Address - Phone:573-760-1501
Practice Address - Fax:573-760-1531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000047051Medicare PIN