Healthcare Provider Details
I. General information
NPI: 1215416847
Provider Name (Legal Business Name): PATIENT SLEEP SUPPLIES INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/14/2018
Last Update Date: 05/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2001 CORPORATE CENTER DR
THOUSAND OAKS CA
91320-1428
US
IV. Provider business mailing address
2001 CORPORATE CENTER DR
THOUSAND OAKS CA
91320-1428
US
V. Phone/Fax
- Phone: 877-823-9310
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
BRIAN
EDWARD
MALCHOW
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 877-823-9310