Healthcare Provider Details

I. General information

NPI: 1326505793
Provider Name (Legal Business Name): OWN SLEEP MEDICINE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2019
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8301 STATE LINE RD STE 208
KANSAS CITY MO
64114-2019
US

IV. Provider business mailing address

8301 STATE LINE RD STE 206
KANSAS CITY MO
64114-2019
US

V. Phone/Fax

Practice location:
  • Phone: 816-775-1069
  • Fax: 816-775-2969
Mailing address:
  • Phone: 168-775-1069
  • Fax: 816-775-2969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. NOLAN CLINT HOOPER
Title or Position: BUSINESS MANAGER
Credential:
Phone: 940-390-7222