Healthcare Provider Details

I. General information

NPI: 1740896695
Provider Name (Legal Business Name): EASTERN IOWA SLEEP SUPPLY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2020
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 10TH ST SE STE 1130-B
CEDAR RAPIDS IA
52403-2450
US

IV. Provider business mailing address

275 10TH ST SE STE 3330
CEDAR RAPIDS IA
52403-2450
US

V. Phone/Fax

Practice location:
  • Phone: 319-362-4433
  • Fax: 319-362-4466
Mailing address:
  • Phone: 319-362-4433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CASEY SEEDORFF-WILSLEF
Title or Position: FINANCE MANAGER
Credential:
Phone: 319-362-4433