MEDICARE: SOUND SLEEP MEDICAL 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	:	1790286433
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUND SLEEP MEDICAL LLC

Provider Business Mailing Address
First Line	:	1075 N WASHINGTON BLVD
Second Line	:
City	:	OGDEN
State	:	UT
Zip	:	84404-3605
Country	:	US
Telephone Number	:	801-528-4889
Fax Number	:	801-396-7031

Provider Business Practice Location Address
First Line	:	1075 N WASHINGTON BLVD
Second Line	:
City	:	OGDEN
State	:	UT
Zip	:	84404-3605
Country	:	US
Telephone Number	:	801-528-4889
Fax Number	:	801-396-7031

Authorized Official
Title or Position	:	MANAGER
Name	:	KIAYA KILPACK
Credential	:	N/A
Telephone Number	:	801-528-4889

Provider Enumeration Date	:	02/27/2018
Last Update Date	:	02/27/2018

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Directions to “SOUND SLEEP MEDICAL LLC ” Practice Location

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