1104889187 NPI number — REMWORKS SLEEP STORE, INC.

Table of content: (NPI 1104889187)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104889187 NPI number — REMWORKS SLEEP STORE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REMWORKS SLEEP STORE, 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:
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:
1104889187
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/14/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1305 S MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MEADVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16335-3036
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-337-0000
Provider Business Mailing Address Fax Number:
814-336-4209

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
159 E BRIDGE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOMESTEAD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15120-5043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-833-1115
Provider Business Practice Location Address Fax Number:
866-624-6958
Provider Enumeration Date:
04/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MOSBACHER
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
D
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
814-337-0000

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  6000001577 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1019384 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com