Provider Demographics
NPI:1760689004
Name:SLEEP & MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:SLEEP & MEDICAL SUPPLY INC
Other - Org Name:SLEEP & MEDICAL SUPPLY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCUBBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:641-613-3283
Mailing Address - Street 1:1106 WASHINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:PELLA
Mailing Address - State:IA
Mailing Address - Zip Code:50219
Mailing Address - Country:US
Mailing Address - Phone:641-613-3283
Mailing Address - Fax:641-621-1601
Practice Address - Street 1:1106 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PELLA
Practice Address - State:IA
Practice Address - Zip Code:50219
Practice Address - Country:US
Practice Address - Phone:641-613-3283
Practice Address - Fax:641-621-1601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21379332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAA01946Medicare UPIN