Healthcare Provider Details

I. General information

NPI: 1144702176
Provider Name (Legal Business Name): SLEEP APNEA SOLUTIONS COLORADO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2018
Last Update Date: 09/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 VILLAGE DR
PAGOSA SPRINGS CO
81147-8308
US

IV. Provider business mailing address

228 VILLAGE DR
PAGOSA SPRINGS CO
81147-8308
US

V. Phone/Fax

Practice location:
  • Phone: 970-731-2126
  • Fax: 970-731-2135
Mailing address:
  • Phone: 970-731-2126
  • Fax: 970-731-2135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberD7043
License Number StateCO

VIII. Authorized Official

Name: DR. GARRETT KING CAMPBELL
Title or Position: OWNER
Credential: DDS
Phone: 970-731-2126