Basic Information
| Provider Information | |||||||||
| NPI: | 1912066325 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SLEEP RIGHT SG, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | SLEEP RIGHT SG | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1661 HOLLAND RD | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | MAUMEE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435374207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4197202005 | ||||||||
| FaxNumber: | 4197202006 | ||||||||
| Practice Location | |||||||||
| Address1: | 1661 HOLLAND RD | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | MAUMEE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435374207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4197202005 | ||||||||
| FaxNumber: | 4197202006 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/08/2006 | ||||||||
| LastUpdateDate: | 04/18/2012 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | MIKHAIL | ||||||||
| AuthorizedOfficialFirstName: | GEORGE | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | COO | ||||||||
| AuthorizedOfficialTelephone: | 4197202005 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | MBA | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.