Healthcare Provider Details

I. General information

NPI: 1548743743
Provider Name (Legal Business Name): DELAWARE SLEEP DISORDER CENTERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2018
Last Update Date: 02/09/2023
Certification Date: 02/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18675 COASTAL HWY UNIT 2A
REHOBOTH BEACH DE
19971-6146
US

IV. Provider business mailing address

261 CHAPMAN RD STE 100
NEWARK DE
19702-5426
US

V. Phone/Fax

Practice location:
  • Phone: 302-652-5109
  • Fax: 302-533-6059
Mailing address:
  • Phone: 302-652-5109
  • Fax: 302-533-6059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: LYRON ANDRE DEPUTY
Title or Position: CEO
Credential:
Phone: 302-449-7484