Healthcare Provider Details
I. General information
NPI: 1043246200
Provider Name (Legal Business Name): SLEEPMED THERAPIES INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/22/2006
Last Update Date: 08/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
760 W SPROUL RD 102A
SPRINGFIELD PA
19064
US
IV. Provider business mailing address
60 CHASTAIN CENTER BLVD NW SUITE 66
KENNESAW GA
30144-5598
US
V. Phone/Fax
- Phone: 610-543-0624
- Fax: 610-543-4086
- Phone: 800-846-2973
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 0007604000 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | INDEPENDENCE BLUE CROSS |
VIII. Authorized Official
Name: MR.
ANGELA
NAUFUL
Title or Position: VP OF COMPLIANCE & CONTRACTING
Credential:
Phone: 770-309-2000