MEDICARE: SLEEP SOLUTIONS OF LACOMBE, L.L.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number	:	1174831671
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLEEP SOLUTIONS OF LACOMBE, L.L.C.

Provider Business Mailing Address
First Line	:	PO BOX 699
Second Line	:
City	:	MADISONVILLE
State	:	LA
Zip	:	70447-0699
Country	:	US
Telephone Number	:	985-875-7557
Fax Number	:	985-875-0595

Provider Business Practice Location Address
First Line	:	64040 HIGHWAY 434
Second Line	:	SUITE 102
City	:	LACOMBE
State	:	LA
Zip	:	70445-3499
Country	:	US
Telephone Number	:	985-882-9200
Fax Number	:	985-882-9090

Authorized Official
Title or Position	:	CEO / MANAGER
Name	:	THOMAS E. LAVIN
Credential	:	MD
Telephone Number	:	985-875-7557

Provider Enumeration Date	:	09/17/2010
Last Update Date	:	09/17/2010

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