Provider Demographics
NPI:1699279521
Name:UNIVERSITY SLEEP MEDICINE LLC
Entity type:Organization
Organization Name:UNIVERSITY SLEEP MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ESKENDER
Authorized Official - Middle Name:
Authorized Official - Last Name:GETACHEW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-854-0300
Mailing Address - Street 1:9039 ANTARES AVE STE B1
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43240-4067
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:885 HIGH ST STE 107
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-4158
Practice Address - Country:US
Practice Address - Phone:614-505-0070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-23
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
36D2064420OtherCLIA