1962431528 NPI number — SLEEPMED THERAPIES INC.

Table of content: (NPI 1962431528)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962431528 NPI number — SLEEPMED THERAPIES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SLEEPMED THERAPIES INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962431528
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/23/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 COBB PLACE BLVD NW
Provider Second Line Business Mailing Address:
SUITE 510
Provider Business Mailing Address City Name:
KENNESAW
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30144-3682
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-846-2973
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 COBB PLACE BLVD NW
Provider Second Line Business Practice Location Address:
SUITE 510
Provider Business Practice Location Address City Name:
KENNESAW
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30144
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-516-5455
Provider Business Practice Location Address Fax Number:
678-260-6702
Provider Enumeration Date:
07/03/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
NAUFUL
Authorized Official First Name:
ANGELA
Authorized Official Middle Name:
Authorized Official Title or Position:
VP OF COMPLIANCE & CONTRACTING
Authorized Official Telephone Number:
770-309-2000

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00885695AB , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10059280 . This is a "AMERIGROUP" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 356411 . This is a "WELLCARE - PIN" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".