Provider Demographics
NPI:1992784185
Name:MIDWEST SLEEP SERVICES, INC.
Entity type:Organization
Organization Name:MIDWEST SLEEP SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPEHEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:ELDER
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:319-629-5691
Mailing Address - Street 1:527 PARK LN
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702-5236
Mailing Address - Country:US
Mailing Address - Phone:319-233-2278
Mailing Address - Fax:
Practice Address - Street 1:527 PARK LN
Practice Address - Street 2:SUITE 400
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5236
Practice Address - Country:US
Practice Address - Phone:319-233-2278
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0458380Medicaid
IA114697Medicare ID - Type Unspecified