Provider Demographics
NPI:1114939089
Name:PSC SLEEP CENTERS, LLC
Entity Type:Organization
Organization Name:PSC SLEEP CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:S
Authorized Official - Last Name:MELLOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-527-5970
Mailing Address - Street 1:430 WOODRUFF RD
Mailing Address - Street 2:SUITE 450
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-3495
Mailing Address - Country:US
Mailing Address - Phone:864-527-5970
Mailing Address - Fax:864-527-5971
Practice Address - Street 1:430 WOODRUFF RD
Practice Address - Street 2:SUITE 450
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-3495
Practice Address - Country:US
Practice Address - Phone:864-527-5970
Practice Address - Fax:864-527-5971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHID02671Medicare PIN
OHPSID02671Medicare ID - Type Unspecified