1982985719 NPI number — MOUNTAIN SLEEP DIAGNOSTICS, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982985719 NPI number — MOUNTAIN SLEEP DIAGNOSTICS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOUNTAIN SLEEP DIAGNOSTICS, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982985719
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
191 TELLURIDE ST UNIT 5
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRIGHTON
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80601-4356
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-396-5923
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8151 SOUTHPARK LN
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
LITTLETON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80120-4502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-396-2992
Provider Business Practice Location Address Fax Number:
303-957-9414
Provider Enumeration Date:
09/07/2011

Additional Information

Authorized Official

Authorized Official Last Name:
GROUNDS-MENARD
Authorized Official First Name:
AUTUMN
Authorized Official Middle Name:
Authorized Official Title or Position:
FINANCE AND OPERATIONS DIRECTOR
Authorized Official Telephone Number:
303-396-5923

Provider Taxonomy Codes

  • Taxonomy code: 261QS1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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