Healthcare Provider Details

I. General information

NPI: 1871504985
Provider Name (Legal Business Name): SLEEPMED INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 05/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3020 SUNSET BLVD SUITE 103 AND 104
WEST COLUMBIA SC
29169-3424
US

IV. Provider business mailing address

700 GERVAIS ST SUITE 200
COLUMBIA SC
29201-3047
US

V. Phone/Fax

Practice location:
  • Phone: 800-373-7326
  • Fax: 803-779-4405
Mailing address:
  • Phone: 978-536-7400
  • Fax: 978-535-9757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH ROSE
Title or Position: VP OF FINANCE & ADMINISTRATION
Credential:
Phone: 978-536-7400