Healthcare Provider Details

I. General information

NPI: 1235678327
Provider Name (Legal Business Name): SLEEP RX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2017
Last Update Date: 02/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5150 N UNION BLVD SUITE 103B
COLORADO SPRINGS CO
80918-2075
US

IV. Provider business mailing address

5204 RELIABLE PKWY
CHICAGO IL
60686-0052
US

V. Phone/Fax

Practice location:
  • Phone: 847-676-4138
  • Fax: 847-676-4148
Mailing address:
  • Phone: 847-676-4138
  • Fax: 847-676-4148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: GRETCHEN A RAKOWICZ
Title or Position: PRESIDENT
Credential:
Phone: 847-676-4138