Healthcare Provider Details

I. General information

NPI: 1487666095
Provider Name (Legal Business Name): SLEEPMED INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 10/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 CORPORATE SQ SUITE G & H
DUBLIN GA
31021-4225
US

IV. Provider business mailing address

60 CHASTAIN BLVD SUITE 66
KENNESAW GA
30144
US

V. Phone/Fax

Practice location:
  • Phone: 800-770-5874
  • Fax: 478-745-5125
Mailing address:
  • Phone: 978-536-7400
  • Fax: 978-535-9757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. CARL R. IBERGER
Title or Position: EVP CFO
Credential:
Phone: 978-536-7400