Provider Demographics
NPI:1316226897
Name:MILLENNIUM SLEEP LAB, LLC
Entity type:Organization
Organization Name:MILLENNIUM SLEEP LAB, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOLTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-942-3700
Mailing Address - Street 1:10820 SUNSET OFFICE DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127-1016
Mailing Address - Country:US
Mailing Address - Phone:314-942-3700
Mailing Address - Fax:844-242-9966
Practice Address - Street 1:10820 SUNSET OFFICE DR
Practice Address - Street 2:SUITE 130
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127-1016
Practice Address - Country:US
Practice Address - Phone:314-942-3700
Practice Address - Fax:888-834-8786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-15
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment