Provider Demographics
NPI:1861840431
Name:ROSEWOOD SLEEP LLC
Entity Type:Organization
Organization Name:ROSEWOOD SLEEP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT (OWNER)
Authorized Official - Prefix:DR
Authorized Official - First Name:LANDON
Authorized Official - Middle Name:BRET
Authorized Official - Last Name:ROCKWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:435-840-0698
Mailing Address - Street 1:181 W VINE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:TOOELE
Mailing Address - State:UT
Mailing Address - Zip Code:84074-2083
Mailing Address - Country:US
Mailing Address - Phone:435-841-9321
Mailing Address - Fax:435-882-1040
Practice Address - Street 1:181 W VINE ST
Practice Address - Street 2:SUITE A
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-2083
Practice Address - Country:US
Practice Address - Phone:435-841-9321
Practice Address - Fax:435-882-1040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5672092332B00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment