Provider Demographics
NPI:1407246101
Name:SLEEP APNEA CARE AND WELLNESS LLC
Entity Type:Organization
Organization Name:SLEEP APNEA CARE AND WELLNESS LLC
Other - Org Name:KOALA CENTER FOR SLEEP DISORDERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:BARR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:715-298-4454
Mailing Address - Street 1:11825 STATE ROUTE 40
Mailing Address - Street 2:STE 100
Mailing Address - City:DUNLAP
Mailing Address - State:IL
Mailing Address - Zip Code:61525-8842
Mailing Address - Country:US
Mailing Address - Phone:309-839-9941
Mailing Address - Fax:309-839-9961
Practice Address - Street 1:305 S 18TH AVE
Practice Address - Street 2:STE 300
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-4208
Practice Address - Country:US
Practice Address - Phone:715-298-4454
Practice Address - Fax:715-802-8568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
7230170001Medicare PIN