Provider Demographics
NPI:1942206370
Name:SLEEPWELL PARTNERS, LLC
Entity Type:Organization
Organization Name:SLEEPWELL PARTNERS, LLC
Other - Org Name:CARDIOSOM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/COO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:JARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-706-1080
Mailing Address - Street 1:615 W. CARMEL DR.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-5504
Mailing Address - Country:US
Mailing Address - Phone:317-706-1080
Mailing Address - Fax:317-574-8674
Practice Address - Street 1:613 FORT UNION BLVD
Practice Address - Street 2:STE 102-A
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-5531
Practice Address - Country:US
Practice Address - Phone:801-523-7533
Practice Address - Fax:801-523-3707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-21
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT45940000002001OtherBLUESHIELD
UTP00417312OtherMEDICARE RAILROAD
UT293382OtherALTIUS
UTP00417312OtherMEDICARE RAILROAD
UT5885200002Medicare NSC