Provider Demographics
NPI:1063728350
Name:SLEEPMED INC
Entity type:Organization
Organization Name:SLEEPMED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE & ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-536-7400
Mailing Address - Street 1:200 CORPORATE PL
Mailing Address - Street 2:5B
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-3840
Mailing Address - Country:US
Mailing Address - Phone:978-536-7400
Mailing Address - Fax:
Practice Address - Street 1:100 TOMMY STALNAKER DRIVE
Practice Address - Street 2:A
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-9174
Practice Address - Country:US
Practice Address - Phone:478-333-2087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-24
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder DiagnosticGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202G705307Medicare PIN