Provider Demographics
NPI:1982061792
Name:SCOTTSDALE SLEEP CLINIC, PLLC
Entity Type:Organization
Organization Name:SCOTTSDALE SLEEP CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STATUTORY AGENT
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-945-3629
Mailing Address - Street 1:9481 E IRONWOOD SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4568
Mailing Address - Country:US
Mailing Address - Phone:480-945-3629
Mailing Address - Fax:480-664-8972
Practice Address - Street 1:9481 E IRONWOOD SQUARE DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4568
Practice Address - Country:US
Practice Address - Phone:480-945-3629
Practice Address - Fax:480-664-8972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-25
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic