Healthcare Provider Details

I. General information

NPI: 1619830858
Provider Name (Legal Business Name): USA SLEEP DIAGNOSTIC MOBILE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 OHEAR AVE STE 100
NORTH CHARLESTON SC
29405-5091
US

IV. Provider business mailing address

6030 DAYBREAK CIR # A150260
CLARKSVILLE MD
21029-1642
US

V. Phone/Fax

Practice location:
  • Phone: 888-792-4445
  • Fax: 888-765-6615
Mailing address:
  • Phone: 888-792-4445
  • Fax: 888-765-6615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: THURLYN BRYAN WILSON
Title or Position: CEO
Credential:
Phone: 888-792-4445