Healthcare Provider Details

I. General information

NPI: 1699070227
Provider Name (Legal Business Name): COLORADO SLEEP COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2011
Last Update Date: 06/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3655 E 104TH AVE SUITE C
THORNTON CO
80233-4469
US

IV. Provider business mailing address

2660 SIERRA DR
COLORADO SPRINGS CO
80917-4033
US

V. Phone/Fax

Practice location:
  • Phone: 303-395-5548
  • Fax:
Mailing address:
  • Phone: 719-492-4574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA D CAST
Title or Position: PRESIDENT
Credential:
Phone: 719-492-4574