Provider Demographics
NPI:1124458021
Name:SLEEP SUPPLY OF FARIBAULT, LLC
Entity type:Organization
Organization Name:SLEEP SUPPLY OF FARIBAULT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NADINE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:ZABINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-441-2104
Mailing Address - Street 1:1575 20TH ST NW
Mailing Address - Street 2:SUITE 209
Mailing Address - City:FARIBAULT
Mailing Address - State:MN
Mailing Address - Zip Code:55021-2930
Mailing Address - Country:US
Mailing Address - Phone:320-441-2104
Mailing Address - Fax:320-441-2052
Practice Address - Street 1:309 LAKELAND DR SE
Practice Address - Street 2:SUITE 3
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-3997
Practice Address - Country:US
Practice Address - Phone:320-441-2104
Practice Address - Fax:320-441-2052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies