MEDICARE: HEALTHY 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	261QH0100X	Health Service Clinic/Center
2	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1881254233
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHY SLEEP CENTER

Provider Business Mailing Address
First Line	:	1040 TRUMP RD NW STE 300
Second Line	:
City	:	CARROLLTON
State	:	OH
Zip	:	44615-9472
Country	:	US
Telephone Number	:	330-944-1020
Fax Number	:

Provider Business Practice Location Address
First Line	:	1040 TRUMP RD NW
Second Line	:
City	:	CARROLLTON
State	:	OH
Zip	:	44615-9472
Country	:	US
Telephone Number	:	330-624-5666
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. DAVID K SEVERSON
Credential	:
Telephone Number	:	330-904-1020

Provider Enumeration Date	:	06/18/2019
Last Update Date	:	10/05/2020

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Directions to “HEALTHY SLEEP CENTER ” Practice Location

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