Provider Demographics
NPI:1033907522
Name:OSCEOLA SLEEP CENTER LLC
Entity type:Organization
Organization Name:OSCEOLA SLEEP CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & PRESIDENT, OPERATING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:OMAE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-737-0533
Mailing Address - Street 1:10600 OLD COUNTY ROAD 15 STE 140
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55441-6201
Mailing Address - Country:US
Mailing Address - Phone:952-737-0533
Mailing Address - Fax:
Practice Address - Street 1:2600 65TH AVE
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:WI
Practice Address - Zip Code:54020-4376
Practice Address - Country:US
Practice Address - Phone:715-294-4755
Practice Address - Fax:715-294-4736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies