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General NPI Number Information
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NPI Number | 1033465653
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Entity Type | Organization
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Legal Business Name | SLEEP SERVICE CENTER LLC
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Dates
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Enumeration Date | 08/01/2012
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Last Update Date | 11/09/2012
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Provider Practice Location Address
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Address Line | 11220 W LAPHAM ST
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City | MILWAUKEE
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State | WI
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Zip | 53214-3806
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Country | US
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Telephone | 414-550-5221
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Fax |
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Provider Business Mailing Address
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Address Line | 11220 W LAPHAM ST
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City | MILWAUKEE
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State | WI
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Zip | 53214-3806
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Country | US
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Telephone | 414-550-5221
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. CHARLES SISSON
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Credential |
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Telephone | 414-550-5221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State | WI
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