Provider Demographics
NPI:1932257359
Name:WHITNEY SLEEP ASSOCIATES
Entity type:Organization
Organization Name:WHITNEY SLEEP ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:WADE
Authorized Official - Last Name:WHITNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:763-519-0634
Mailing Address - Street 1:2700 CAMPUS DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55441-2601
Mailing Address - Country:US
Mailing Address - Phone:763-519-0634
Mailing Address - Fax:763-519-0636
Practice Address - Street 1:2700 CAMPUS DR
Practice Address - Street 2:SUITE 100
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55441-2601
Practice Address - Country:US
Practice Address - Phone:763-519-0634
Practice Address - Fax:763-519-0636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN991942200Medicaid