1700018660 NPI number — MONTROSE SLEEP CENTER, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700018660 NPI number — MONTROSE SLEEP CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MONTROSE SLEEP CENTER, LLC
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:
6
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:
1700018660
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/11/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4125 MEDINA RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AKRON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44333-2483
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-665-8211
Provider Business Mailing Address Fax Number:
330-665-8215

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10633 PEARL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STRONGSVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44136-1405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-665-8211
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/11/2009

Additional Information

Authorized Official

Authorized Official Last Name:
BEEBE
Authorized Official First Name:
MARK
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER, SLEEP CENTERS
Authorized Official Telephone Number:
330-665-8211

Provider Taxonomy Codes

  • Taxonomy code: 293D00000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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