Provider Demographics
NPI:1457655698
Name:DELTA SLEEP'S CPAP STORE
Entity Type:Organization
Organization Name:DELTA SLEEP'S CPAP STORE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:LEHANE
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:309-663-2727
Mailing Address - Street 1:2416 E WASHINGTON ST
Mailing Address - Street 2:STE. D4
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61704-4472
Mailing Address - Country:US
Mailing Address - Phone:309-663-2727
Mailing Address - Fax:309-663-1818
Practice Address - Street 1:2416 E WASHINGTON ST
Practice Address - Street 2:STE. D4
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61704-4472
Practice Address - Country:US
Practice Address - Phone:309-663-2727
Practice Address - Fax:309-663-1818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-03
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies