Provider Demographics
NPI:1063688109
Name:SLEEPCARE CENTER, INC.
Entity Type:Organization
Organization Name:SLEEPCARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATIVE OFFICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:DONOVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-234-0770
Mailing Address - Street 1:130 GAITHER DR
Mailing Address - Street 2:STE: 124
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-1715
Mailing Address - Country:US
Mailing Address - Phone:856-234-0770
Mailing Address - Fax:856-234-5010
Practice Address - Street 1:8080 OLD YORK RD
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-1421
Practice Address - Country:US
Practice Address - Phone:856-234-0770
Practice Address - Fax:856-234-5010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA028599Medicare PIN