MEDICARE: SLEEP MANAGEMENT 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	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	50016573	OTHER	KY	PASSPORT
2	000000502891	OTHER	KY	ANTHEM

General Provider Information

NPI Number	:	1730243791
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLEEP MANAGEMENT LLC

Provider Business Mailing Address
First Line	:	6100 DUTCHMANS LN
Second Line	:	SUITE 302
City	:	LOUISVILLE
State	:	KY
Zip	:	40205-3284
Country	:	US
Telephone Number	:	502-479-1073
Fax Number	:	502-479-1074

Provider Business Practice Location Address
First Line	:	6100 DUTCHMANS LN
Second Line	:	SUITE 302
City	:	LOUISVILLE
State	:	KY
Zip	:	40205-3284
Country	:	US
Telephone Number	:	502-479-1073
Fax Number	:	502-479-1074

Authorized Official
Title or Position	:	OWNER PRESIDENT
Name	:	HAL A VONSICK
Credential	:
Telephone Number	:	502-479-1073

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	12/12/2008

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Directions to “SLEEP MANAGEMENT LLC ” Practice Location

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