Healthcare Provider Details

I. General information

NPI: 1497902928
Provider Name (Legal Business Name): NEVADA SLEEP DIAGNOSTICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2008
Last Update Date: 01/06/2020
Certification Date: 01/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 S BLAGG RD
PAHRUMP NV
89048-2112
US

IV. Provider business mailing address

8935 S PECOS RD STE 22D
HENDERSON NV
89074-7155
US

V. Phone/Fax

Practice location:
  • Phone: 702-990-7660
  • Fax: 702-990-7665
Mailing address:
  • Phone: 702-990-7660
  • Fax: 702-990-7665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number9072
License Number StateNV

VIII. Authorized Official

Name: MR. ROBERT H LABANOWSKI
Title or Position: COO/CFO
Credential: CPA
Phone: 702-990-7660