Provider Demographics
NPI:1992836647
Name:GAMMA SLEEP DIAGNOSTIC CENTER LLC
Entity Type:Organization
Organization Name:GAMMA SLEEP DIAGNOSTIC CENTER LLC
Other - Org Name:ALPHASLEEP DIAGNOSTIC CENTERS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:RENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-407-1990
Mailing Address - Street 1:650 S CHERRY STREET
Mailing Address - Street 2:SUITE 430
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246
Mailing Address - Country:US
Mailing Address - Phone:303-407-1990
Mailing Address - Fax:303-407-5098
Practice Address - Street 1:9218 KIMMER DRIVE
Practice Address - Street 2:SUITE 206
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124
Practice Address - Country:US
Practice Address - Phone:303-407-1990
Practice Address - Fax:303-407-5098
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALPHASLEEP DIAGNOSTIC CENTERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOB4136Medicare PIN