Provider Demographics
NPI:1952662496
Name:KEARNEY SLEEP LAB, LLC
Entity Type:Organization
Organization Name:KEARNEY SLEEP LAB, LLC
Other - Org Name:KEARNEY SLEEP LAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-592-2435
Mailing Address - Street 1:9931 S 136TH ST
Mailing Address - Street 2:STE 100
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68138
Mailing Address - Country:US
Mailing Address - Phone:402-592-2435
Mailing Address - Fax:402-592-6914
Practice Address - Street 1:109 E 52ND ST
Practice Address - Street 2:SUITE 2
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-0502
Practice Address - Country:US
Practice Address - Phone:309-455-1331
Practice Address - Fax:308-225-5491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-31
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic