1063626851 NPI number — TOTAL SLEEP DIAGNOSTICS OF KANSAS, INC

Table of content: (NPI 1063626851)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063626851 NPI number — TOTAL SLEEP DIAGNOSTICS OF KANSAS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOTAL SLEEP DIAGNOSTICS OF KANSAS, 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:
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:
1063626851
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4 SAINT ANN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MANDEVILLE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70471-3265
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
985-626-6211
Provider Business Mailing Address Fax Number:
985-626-6227

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13470 S ARAPAHO DR STE 170
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OLATHE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66062-1656
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-393-0464
Provider Business Practice Location Address Fax Number:
913-393-0698
Provider Enumeration Date:
05/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RIVAS
Authorized Official First Name:
BETSY
Authorized Official Middle Name:
Authorized Official Title or Position:
AR DIRECTOR
Authorized Official Telephone Number:
985-626-6211

Provider Taxonomy Codes

  • Taxonomy code: 247200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 27513021 . This is a "BCBS PROVIDER NUMBER" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".




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