Provider Demographics
NPI:1366463184
Name:SPECTRUM SLEEP DIAGNOSTICS INC
Entity Type:Organization
Organization Name:SPECTRUM SLEEP DIAGNOSTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:L
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:CRT,RCP
Authorized Official - Phone:913-831-2979
Mailing Address - Street 1:1150 WEST 75TH STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66102
Mailing Address - Country:US
Mailing Address - Phone:913-831-2979
Mailing Address - Fax:913-831-9566
Practice Address - Street 1:1150 W. 75TH STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102
Practice Address - Country:US
Practice Address - Phone:913-831-2979
Practice Address - Fax:913-831-9566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
2204OtherEFTPS NUMBER
2204OtherEFTPS NUMBER