Provider Demographics
NPI:1750413266
Name:SLEEPRITE MEDICAL LLC
Entity type:Organization
Organization Name:SLEEPRITE MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER,RESPIRATORY THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DARRYL
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:RAJKOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:RT, RPSGT
Authorized Official - Phone:218-362-8000
Mailing Address - Street 1:2139 1ST AVE.
Mailing Address - Street 2:
Mailing Address - City:HIBBING
Mailing Address - State:MN
Mailing Address - Zip Code:55746-2012
Mailing Address - Country:US
Mailing Address - Phone:218-362-8000
Mailing Address - Fax:218-362-8000
Practice Address - Street 1:2139 1ST AVE.
Practice Address - Street 2:
Practice Address - City:HIBBING
Practice Address - State:MN
Practice Address - Zip Code:55746-2012
Practice Address - Country:US
Practice Address - Phone:218-362-8000
Practice Address - Fax:218-362-8000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-10
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5057529332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1025958OtherPREFERRED ONE
MN36G71SLOtherFIRST PLAN OF MN
MN335423700Medicaid
MN36G71SLOtherBCBS OF MN