Basic Information
| Provider Information | |||||||||
| NPI: | 1801092879 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SLEEPMED THERAPIES, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 60 CHASTAIN CENTER BLVD NW | ||||||||
| Address2: | SUITE 66 | ||||||||
| City: | KENNESAW | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301445598 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7705925544 | ||||||||
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| Practice Location | |||||||||
| Address1: | 154 BURNETTS WAY | ||||||||
| Address2: | SUITE 101-C | ||||||||
| City: | SUFFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 234348366 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9785367400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2007 | ||||||||
| LastUpdateDate: | 10/21/2009 | ||||||||
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| AuthorizedOfficialLastName: | IBERGER | ||||||||
| AuthorizedOfficialFirstName: | CARL | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | EVP-CFO | ||||||||
| AuthorizedOfficialTelephone: | 9785367400 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
ID Information
| ID | Type | State | Issuer | Description | 2168698 | 01 | VA | OPTIMUM CHOICE | OTHER | 2168698 | 01 | VA | MAMSI | OTHER | 2168698 | 01 | VA | MDIPA | OTHER | 2168698 | 01 | VA | ONENET PPO | OTHER | 8201299 | 01 | VA | AMERICHOICE | OTHER | 7618325 | 01 | VA | AETNA | OTHER |