Provider Demographics
NPI:1669723425
Name:SLEEP SERVICE CENTER LLC
Entity type:Organization
Organization Name:SLEEP SERVICE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KERSTETTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-282-5451
Mailing Address - Street 1:11220 W LAPHAM ST
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53214-3806
Mailing Address - Country:US
Mailing Address - Phone:414-282-5451
Mailing Address - Fax:414-282-5467
Practice Address - Street 1:11220 W LAPHAM ST
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53214-3806
Practice Address - Country:US
Practice Address - Phone:414-282-5451
Practice Address - Fax:414-282-5467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies