MEDICARE: SERENITY SLEEP SOLUTIONS OF QUINCY, LLC

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	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1316455835
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITY SLEEP SOLUTIONS OF QUINCY, LLC

Provider Business Mailing Address
First Line	:	3800 E LAKE CTR STE 100
Second Line	:
City	:	QUINCY
State	:	IL
Zip	:	62305-5839
Country	:	US
Telephone Number	:	217-257-0386
Fax Number	:

Provider Business Practice Location Address
First Line	:	3800 E LAKE CTR
Second Line	:
City	:	QUINCY
State	:	IL
Zip	:	62305-5839
Country	:	US
Telephone Number	:	217-214-7222
Fax Number	:	217-403-9200

Authorized Official
Title or Position	:	DENTIST
Name	:	KENT J STURHAHN
Credential	:	DMD
Telephone Number	:	217-257-0386

Provider Enumeration Date	:	01/18/2018
Last Update Date	:	11/02/2023

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