MEDICARE: CASTLE ROCK SLEEP CENTER

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	:	1629110937
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CASTLE ROCK SLEEP CENTER

Provider Business Mailing Address
First Line	:	1849 AUSTIN BLUFFS PKWY
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-7843
Country	:	US
Telephone Number	:	719-387-9695
Fax Number	:	719-387-8685

Provider Business Practice Location Address
First Line	:	1189 S PERRY ST
Second Line	:	SUITE 110D
City	:	CASTLE ROCK
State	:	CO
Zip	:	80104-1959
Country	:	US
Telephone Number	:	719-387-8685
Fax Number	:	719-387-8690

Authorized Official
Title or Position	:	CEO
Name	:	MIKE THURMAN
Credential	:
Telephone Number	:	303-395-5548

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	07/19/2010

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Directions to “CASTLE ROCK SLEEP CENTER ” Practice Location

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