1467635805 NPI number — TOLEDO SLEEP DISORDERS CENTER

Table of content: (NPI 1467635805)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467635805 NPI number — TOLEDO SLEEP DISORDERS CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOLEDO SLEEP DISORDERS CENTER
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:
1467635805
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/07/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1661 HOLLAND RD
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
MAUMEE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43537
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-794-8200
Provider Business Mailing Address Fax Number:
419-724-1892

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2702 NAVARRE AVE
Provider Second Line Business Practice Location Address:
SUITE 302
Provider Business Practice Location Address City Name:
OREGON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43616-3223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-693-9727
Provider Business Practice Location Address Fax Number:
419-693-9737
Provider Enumeration Date:
12/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MIKHAIL
Authorized Official First Name:
GEORGE
Authorized Official Middle Name:
R.
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
419-794-8200

Provider Taxonomy Codes

  • Taxonomy code: 261QS1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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