Provider Demographics
NPI:1073511770
Name:ROCK HILL SLEEP CENTER, LLC
Entity Type:Organization
Organization Name:ROCK HILL SLEEP CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:BARGER
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:800-486-2620
Mailing Address - Street 1:7200 NW 19TH ST
Mailing Address - Street 2:600
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1200
Mailing Address - Country:US
Mailing Address - Phone:305-500-2000
Mailing Address - Fax:305-500-2155
Practice Address - Street 1:430 S HERLONG AVE
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-9446
Practice Address - Country:US
Practice Address - Phone:803-980-4949
Practice Address - Fax:803-980-4950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21139261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC=========OtherBLUE CROSS OF SC PROVIDER
SCQ337260001Medicare PIN
SC=========OtherBLUE CROSS OF SC PROVIDER