Healthcare Provider Details

I. General information

NPI: 1477645620
Provider Name (Legal Business Name): SLEEPMED INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1333 TAYLOR ST SUITE 6B
COLUMBIA SC
29201-2923
US

IV. Provider business mailing address

700 GERVAIS ST SUITE 210
COLUMBIA SC
29201-3047
US

V. Phone/Fax

Practice location:
  • Phone: 803-296-5847
  • Fax: 803-376-1876
Mailing address:
  • Phone: 978-536-7400
  • Fax: 978-535-9757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) 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