Provider Demographics
NPI:1588116255
Name:SLEEP MEDICAL CENTER OF TRI-CITIES, LLC
Entity type:Organization
Organization Name:SLEEP MEDICAL CENTER OF TRI-CITIES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-627-6888
Mailing Address - Street 1:475 KEENE RD
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-5007
Mailing Address - Country:US
Mailing Address - Phone:509-627-6888
Mailing Address - Fax:
Practice Address - Street 1:9521 SANDIFUR PKWY STE 1
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-9105
Practice Address - Country:US
Practice Address - Phone:509-627-6888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-28
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment