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Organization
SLEEPWELL PARTNER LLC
Active
Organization
SLEEPWELL PARTNER LLC
Active
Parent organization
AVASTRA USA
Organization subpart
Yes
Provider details
NPI number
Legal business name
AVASTRA USA
Authorized official
MR. KEITH GREISL (PRESIDENT/ COO)
(317) 706-1080
Entity
Organization
Contact information
Practice address
12901 SE 97TH AVE, CLACKAMAS, OR 97015-7901
(503) 652-0067
(503) 652-0068
Mailing address
615 W CARMEL DR, SUITE 100, CARMEL, IN 46032-5504
(317) 706-1080
(317) 706-1022
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
247423
—
OR
01
—
820243000
BLUESHIELD
OR
Enumeration date
06/21/2005
Last updated
03/31/2010
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