Healthcare Provider Details

I. General information

NPI: 1992836647
Provider Name (Legal Business Name): GAMMA SLEEP DIAGNOSTIC CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 10/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9218 KIMMER DRIVE SUITE 206
LONE TREE CO
80124
US

IV. Provider business mailing address

650 S CHERRY STREET SUITE 430
DENVER CO
80246
US

V. Phone/Fax

Practice location:
  • Phone: 303-407-1990
  • Fax: 303-407-5098
Mailing address:
  • Phone: 303-407-1990
  • Fax: 303-407-5098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. RENA BACH
Title or Position: VICE PRESIDENT
Credential:
Phone: 303-407-1990