Provider Demographics
NPI:1225314024
Name:2ND WIND SLEEP MEDICAL EQUIPMENT, LLC
Entity type:Organization
Organization Name:2ND WIND SLEEP MEDICAL EQUIPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO-CO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:PATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-981-2837
Mailing Address - Street 1:110 HICKORY ST NW
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-1724
Mailing Address - Country:US
Mailing Address - Phone:541-981-2837
Mailing Address - Fax:541-704-0721
Practice Address - Street 1:9900 SW GREENBURG RD
Practice Address - Street 2:SUITE 275
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-5502
Practice Address - Country:US
Practice Address - Phone:503-747-6857
Practice Address - Fax:541-747-6891
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:2ND WIND SLEEP MEDICAL EQUIPMENT, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-25
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR356726-90332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies