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Organization

OMNISLEEP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOHN CRAIG EAVES (CEO)
(505) 843-8758
Entity
Organization

Contact information

Practice address
3810 MASTHEAD ST NE, ALBUQUERQUE, NM 87109-4479
(505) 843-8758
(505) 843-9269
Mailing address
3810 MASTHEAD ST NE, ALBUQUERQUE, NM 87109-4479
(505) 843-8758
(505) 843-9269

Taxonomy

Speciality
Code
Description
License number
State
207QS1201X
Sleep Medicine (Family Medicine) Physician
207R00000X
Internal Medicine Physician
207RS0012X
Sleep Medicine (Internal Medicine) Physician
2080S0012X
Pediatric Sleep Medicine Physician
208D00000X
General Practice Physician
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
363AM0700X
Medical Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
95877321
NM
Enumeration date
06/18/2009
Last updated
05/07/2024
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