Organization
LOUISVILLE SLEEP DISORDERS CENTER LLC
Active
Other names
American Sleep Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA HOLMES (ADMINISTRATOR)
(502) 899-9199
Entity
Organization
Contact information
Practice address
4010 DUPONT CIR STE 122, LOUISVILLE, KY 40207-4842
(502) 899-9199
(502) 899-1617
Mailing address
4010 DUPONT CIR STE 122, LOUISVILLE, KY 40207-4842
(502) 899-9199
(502) 899-1617
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
730067
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5005511
KY PASSPORT ID NUMBER
KY
05
—
65941007
—
KY
01
—
P00077209
MEDICARE RR ID NUMBER
KY
Enumeration date
07/21/2006
Last updated
10/03/2024
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