MEDICARE: GENEVA/MADISON SLEEP CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	35040889-D	OH

General Provider Information

NPI Number	:	1780845685
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENEVA/MADISON SLEEP CENTER

Provider Business Mailing Address
First Line	:	21 W MAIN ST
Second Line	:
City	:	MADISON
State	:	OH
Zip	:	44057-3125
Country	:	US
Telephone Number	:	440-285-9598
Fax Number	:

Provider Business Practice Location Address
First Line	:	13221 RAVENNA RD STE 13
Second Line	:
City	:	CHARDON
State	:	OH
Zip	:	44024-9016
Country	:	US
Telephone Number	:	440-285-9598
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. ANTHONY F DIMARCO
Credential	:	M.D.
Telephone Number	:	440-285-9598

Provider Enumeration Date	:	06/23/2008
Last Update Date	:	06/23/2008

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Directions to “GENEVA/MADISON SLEEP CENTER ” Practice Location

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