Healthcare Provider Details
I. General information
NPI: 1841587813
Provider Name (Legal Business Name): REMEDY SLEEP MEDICINE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/29/2011
Last Update Date: 02/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8625 COLLEGE BLVD SUITE 103
OVERLAND PARK KS
66210-1835
US
IV. Provider business mailing address
15621 W 87TH ST SUITE 221
LENEXA KS
66219-1435
US
V. Phone/Fax
- Phone: 913-777-0077
- Fax: 877-796-6309
- Phone: 913-777-0077
- Fax: 877-796-6309
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QS1201X |
| Taxonomy | Sleep Medicine (Family Medicine) Physician |
| License Number | 04-28951 |
| License Number State | KS |
VIII. Authorized Official
Name:
CAROLE
A.
GUILLAUME
Title or Position: OWNER
Credential: MD, FAASM
Phone: 913-777-0077