Provider Demographics
NPI:1053505776
Name:SLEEPMED, INC
Entity Type:Organization
Organization Name:SLEEPMED, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP-CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:R
Authorized Official - Last Name:IBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-536-7400
Mailing Address - Street 1:60 CHASTAIN CENTER BLVD NW
Mailing Address - Street 2:SUITE 66
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-5598
Mailing Address - Country:US
Mailing Address - Phone:770-516-5455
Mailing Address - Fax:978-536-6322
Practice Address - Street 1:900 SANDERS RD
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-5960
Practice Address - Country:US
Practice Address - Phone:678-455-9619
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
47001139OtherRR MEDICARE
GA511G470020Medicare PIN