SLEEP SOURCE KENTUCKY LLC NPI 1174771018

NPI Information

NPI: 1174771018
Provider Name: SLEEP SOURCE KENTUCKY, LLC

Other Name: KENTUCKY SLEEP CENTER

Classification: Clinic/Center - 261QS1200X
Entity Type: Organization

Specialization: Sleep Disorder Diagnostic

Address:
3125 PARISA DRIVE
PADUCAH, KY
ZIP 42003
Phone: (270) 575-0080
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SLEEP SOURCE KENTUCKY, LLC is a sleep disorder diagnostic clinic center in Paducah, KY. SLEEP SOURCE KENTUCKY, LLC NPI is 1174771018. The provider is registered as an organization entity type.
The provider Other Name Is Kentucky Sleep Center.

The provider's business location address is:

3125 PARISA DRIVE
PADUCAH, KY
ZIP 42003
Phone: (270) 575-0080
Fax: (270) 575-0081

The provider's authorized official is Mark Sexton .
The authorized official title is Co-owner and has the following contact phone number (270) 575-0080.

The CLIA number assigned to this NPI record is 18D2290893 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/4/2008 and was last updated on 5/19/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QS1200X	Clinic/Center	Sleep Disorder Diagnostic			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	9377901	MEDICARE PIN	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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