Organization
IDAHO SLEEP SERVICES, LLC
Active
Other names
Idaho Sleep Health
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD J BEASLEY MD (MANAGER)
(208) 463-3000
Entity
Organization
Contact information
Practice address
210 GEORGIA AVE, STE 120, NAMPA, ID 83686
(208) 442-8222
(208) 442-8232
Mailing address
PO BOX 3291, SALT LAKE CITY, UT 84110-3291
(208) 375-8222
(208) 375-8232
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
M9815
ID
177F00000X
Lodging Provider
—
—
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
ID
291U00000X
Clinical Medical Laboratory
—
ID
293D00000X
Physiological Laboratory
—
—
Other
Enumeration date
04/17/2007
Last updated
02/03/2011
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