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Organization
SOUTHERN MISSOURI SLEEP CENTER, LLC
Active
Organization
SOUTHERN MISSOURI SLEEP CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LYNDA NEWMAN (DIRECTOR OF PATIENT CARE)
(314) 645-5855
Entity
Organization
Contact information
Practice address
2210 BARRON RD STE 117, POPLAR BLUFF, MO 63901-1922
(573) 727-9661
(573) 727-9665
Mailing address
PO BOX 771933, SAINT LOUIS, MO 63177-1933
(573) 727-9661
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201634
BLUE CROSS
MO
05
—
716394501
—
MO
Enumeration date
10/06/2006
Last updated
03/12/2024
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