Provider Demographics
NPI:1144428251
Name:SLEEP HEALTH DIAGNOSTICS,LLC.
Entity Type:Organization
Organization Name:SLEEP HEALTH DIAGNOSTICS,LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOLLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-830-1543
Mailing Address - Street 1:975 EASTWIND DR
Mailing Address - Street 2:SUITE 165
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-5322
Mailing Address - Country:US
Mailing Address - Phone:877-753-3742
Mailing Address - Fax:855-888-6947
Practice Address - Street 1:780 CANTON RD NE
Practice Address - Street 2:SUITE 310
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-7241
Practice Address - Country:US
Practice Address - Phone:770-426-6611
Practice Address - Fax:770-426-6611
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOOD NIGHT MEDICAL, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-10
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder DiagnosticGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA47BBBNFMedicare PIN