MEDICARE: HOME SLEEP TESTING OF LOUISIANA

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	261QS1200X	Sleep Disorder Diagnostic Clinic/Center		LA

General Provider Information

NPI Number	:	1295030351
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME SLEEP TESTING OF LOUISIANA

Provider Business Mailing Address
First Line	:	3825 GILBERT DR
Second Line	:	STE 127
City	:	SHREVEPORT
State	:	LA
Zip	:	71104-5000
Country	:	US
Telephone Number	:	318-423-8715
Fax Number	:

Provider Business Practice Location Address
First Line	:	3825 GILBERT DR
Second Line	:	STE 127
City	:	SHREVEPORT
State	:	LA
Zip	:	71104-5000
Country	:	US
Telephone Number	:	318-423-8715
Fax Number	:

Authorized Official
Title or Position	:	MBR
Name	:	WES MCLELLAND
Credential	:
Telephone Number	:	318-423-8715

Provider Enumeration Date	:	01/21/2011
Last Update Date	:	01/21/2011

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Directions to “HOME SLEEP TESTING OF LOUISIANA ” Practice Location

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