MEDICARE: LAKELAND SLEEP & CPAP - RAPID CITY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies		MN
2	261QS1200X	Sleep Disorder Diagnostic Clinic/Center		MN

General Provider Information

NPI Number	:	1144462219
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAKELAND SLEEP & CPAP - RAPID CITY

Provider Business Mailing Address
First Line	:	10600 OLD COUNTY ROAD 15 STE 140
Second Line	:
City	:	PLYMOUTH
State	:	MN
Zip	:	55441-6201
Country	:	US
Telephone Number	:	763-512-1551
Fax Number	:	763-354-7647

Provider Business Practice Location Address
First Line	:	2640 JACKSON BLVD
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57702-3400
Country	:	US
Telephone Number	:	763-512-1551
Fax Number	:

Authorized Official
Title or Position	:	CEO & PRESIDENT
Name	:	GEORGE OMAE
Credential	:
Telephone Number	:	763-354-7648

Provider Enumeration Date	:	04/03/2009
Last Update Date	:	01/14/2026

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Directions to “LAKELAND SLEEP & CPAP - RAPID CITY ” Practice Location

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