Healthcare Provider Details

I. General information

NPI: 1295917516
Provider Name (Legal Business Name): SLEEPMED INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2007
Last Update Date: 10/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 HOSPITAL DRIVE SUITE 130
MT PLEASANT SC
29464-3204
US

IV. Provider business mailing address

700 GERVAIS ST
COLUMBIA SC
29201-3047
US

V. Phone/Fax

Practice location:
  • Phone: 978-536-7400
  • Fax:
Mailing address:
  • Phone: 978-536-7400
  • Fax:

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