Healthcare Provider Details

I. General information

NPI: 1730142209
Provider Name (Legal Business Name): THE SLEEP INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 07/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 VALENCIA
IDAHO FALLS ID
83404
US

IV. Provider business mailing address

2900 VALENCIA
IDAHO FALLS ID
83404
US

V. Phone/Fax

Practice location:
  • Phone: 208-523-7667
  • Fax: 208-523-7668
Mailing address:
  • Phone: 208-523-7667
  • Fax: 208-523-7668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License NumberM7579
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberM7579
License Number StateID

VIII. Authorized Official

Name: DARON L SCHERR
Title or Position: OWNER/PRESIDNET
Credential: M.D.
Phone: 208-523-7667