Provider Demographics
NPI:1760955595
Name:SANDMAN SLEEP SERVICES LLC
Entity Type:Organization
Organization Name:SANDMAN SLEEP SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:KOZAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-818-7599
Mailing Address - Street 1:4500 MERCANTILE PLAZA DR STE 347
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76137-4225
Mailing Address - Country:US
Mailing Address - Phone:817-818-7599
Mailing Address - Fax:
Practice Address - Street 1:4500 MERCANTILE PLAZA DR STE 347
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76137-4225
Practice Address - Country:US
Practice Address - Phone:817-818-7599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies