Provider Demographics
NPI:1538290267
Name:DELTASLEEP DIAGNOSTIC CENTER LLC
Entity Type:Organization
Organization Name:DELTASLEEP DIAGNOSTIC CENTER LLC
Other - Org Name:ALPHASLEEP DIAGNOSTIC CENTERS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-407-1990
Mailing Address - Street 1:650 S CHERRY ST STE 430
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1896
Mailing Address - Country:US
Mailing Address - Phone:303-407-1990
Mailing Address - Fax:303-407-5098
Practice Address - Street 1:34 VAN GORDON ST STE 260
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1713
Practice Address - Country:US
Practice Address - Phone:303-407-1990
Practice Address - Fax:303-407-5098
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALPHASLEEP DIAGNOSTIC CENTERS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-07
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC804428Medicare PIN