MEDICARE: SERENITY SLEEP SOLUTIONS OF MISSOURI LLC

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	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1205459203
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITY SLEEP SOLUTIONS OF MISSOURI LLC

Provider Business Mailing Address
First Line	:	34626 150TH AVE
Second Line	:
City	:	PLEASANT HILL
State	:	IL
Zip	:	62366-2150
Country	:	US
Telephone Number	:	217-257-0386
Fax Number	:	217-403-9200

Provider Business Practice Location Address
First Line	:	1601 E BROADWAY STE 160
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65201-5821
Country	:	US
Telephone Number	:	573-447-8648
Fax Number	:	217-403-9200

Authorized Official
Title or Position	:	OWNER
Name	:	DAUNN STURHAHN
Credential	:
Telephone Number	:	217-257-0386

Provider Enumeration Date	:	05/26/2020
Last Update Date	:	11/02/2023

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