Healthcare Provider Details

I. General information

NPI: 1801074877
Provider Name (Legal Business Name): WRINKLE RESPIRATORY AND DME INC. DBA SLEEP TECHNOLOGIES LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2008
Last Update Date: 07/04/2025
Certification Date: 07/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 OTTER CREEK CIR STE C
MABELVALE AR
72103-1680
US

IV. Provider business mailing address

PO BOX 30151
LITTLE ROCK AR
72260-0003
US

V. Phone/Fax

Practice location:
  • Phone: 503-496-5239
  • Fax: 503-343-6554
Mailing address:
  • Phone: 503-496-5239
  • Fax: 503-343-6554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number306516-60-001
License Number StateAR

VIII. Authorized Official

Name: PAULA D LANCE
Title or Position: CHIEF OPERATIONS OFFICER
Credential: CRT
Phone: 503-496-5239