Provider Demographics
NPI:1376873901
Name:SLEEP MANAGEMENT INSTITUTE OF WEST FRANKFORT LLC
Entity Type:Organization
Organization Name:SLEEP MANAGEMENT INSTITUTE OF WEST FRANKFORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:STRADTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-827-3291
Mailing Address - Street 1:420 NW 5TH ST
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47708-1314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:215 N LOGAN ST
Practice Address - Street 2:SUITE B
Practice Address - City:WEST FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:62896-2314
Practice Address - Country:US
Practice Address - Phone:812-827-3291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-04
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic