MEDICARE: CAPITAL SLEEP CENTER, LTD

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	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number	:	1902903073
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAPITAL SLEEP CENTER, LTD

Provider Business Mailing Address
First Line	:	PO BOX 73604
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44193-0002
Country	:	US
Telephone Number	:	614-246-0285
Fax Number	:	614-246-0486

Provider Business Practice Location Address
First Line	:	1810 MACKENZIE DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-2967
Country	:	US
Telephone Number	:	614-246-0285
Fax Number	:	614-246-0486

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	JAMES BARLOW
Credential	:
Telephone Number	:	614-273-2246

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	10/23/2007

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