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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