Provider Demographics
NPI:1376518043
Name:INTEGRATED SLEEP RESOURCES, INC.
Entity Type:Organization
Organization Name:INTEGRATED SLEEP RESOURCES, INC.
Other - Org Name:INTEGRATED CAREGROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/GM
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:BLOSSER
Authorized Official - Suffix:
Authorized Official - Credentials:BSW
Authorized Official - Phone:903-357-3391
Mailing Address - Street 1:10551 BARKLEY ST
Mailing Address - Street 2:STE 106
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-1812
Mailing Address - Country:US
Mailing Address - Phone:888-448-6664
Mailing Address - Fax:888-582-2254
Practice Address - Street 1:10551 BARKLEY ST
Practice Address - Street 2:STE 106
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-1812
Practice Address - Country:US
Practice Address - Phone:888-448-6664
Practice Address - Fax:888-582-2254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-17
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS16-101174332B00000X
FL1789332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS16-101174OtherKANSAS STATE BOARD OF PHARMACY
FL5238340001Medicare NSC