Provider Demographics
NPI:1629110937
Name:CASTLE ROCK SLEEP CENTER
Entity Type:Organization
Organization Name:CASTLE ROCK SLEEP CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:THURMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-395-5548
Mailing Address - Street 1:1849 AUSTIN BLUFFS PKWY
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-7843
Mailing Address - Country:US
Mailing Address - Phone:719-387-9695
Mailing Address - Fax:719-387-8685
Practice Address - Street 1:1189 S PERRY ST
Practice Address - Street 2:SUITE 110D
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1959
Practice Address - Country:US
Practice Address - Phone:719-387-8685
Practice Address - Fax:719-387-8690
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SLEEP COLORADO INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-13
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC808467Medicare PIN