MEDICARE: AMERICAN SLEEP PRODUCTS, 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	HME00871	KY

General Provider Information

NPI Number	:	1972901379
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN SLEEP PRODUCTS, LLC

Provider Business Mailing Address
First Line	:	7900 BELFORT PKWY STE 301B
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-6931
Country	:	US
Telephone Number	:	904-517-5537
Fax Number	:	904-517-5542

Provider Business Practice Location Address
First Line	:	4010 DUPONT CIR
Second Line	:	SUITE #124
City	:	LOUISVILLE
State	:	KY
Zip	:	40207-4812
Country	:	US
Telephone Number	:	502-895-7310
Fax Number	:	502-895-7311

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JIM EVANGER
Credential	:
Telephone Number	:	904-517-5540

Provider Enumeration Date	:	12/17/2014
Last Update Date	:	01/27/2015

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