Healthcare Provider Details

I. General information

NPI: 1487942751
Provider Name (Legal Business Name): SLEEP ALTERNATIVES SALT LAKE , LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2011
Last Update Date: 07/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1226 W SOUTH JORDAN PKWY SUITE B101
SOUTH JORDAN UT
84095-5518
US

IV. Provider business mailing address

609 E SILVERWOOD DR
PHOENIX AZ
85048-1972
US

V. Phone/Fax

Practice location:
  • Phone: 801-302-8172
  • Fax: 866-899-2703
Mailing address:
  • Phone: 602-460-6596
  • Fax: 480-219-1647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
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: ELLEN CREAN
Title or Position: OWNER , CEO
Credential:
Phone: 602-460-6596