Provider Demographics
NPI:1164612347
Name:BIOSERENITY USA, INC.
Entity Type:Organization
Organization Name:BIOSERENITY USA, INC.
Other - Org Name:SLEEPMED, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VP COMPLIANCE & CONTRACTING
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-532-3757
Mailing Address - Street 1:200 CORPORATE PL
Mailing Address - Street 2:SUITE 5B
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-3840
Mailing Address - Country:US
Mailing Address - Phone:978-536-7400
Mailing Address - Fax:
Practice Address - Street 1:25000 COUNTRY CLUB BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070
Practice Address - Country:US
Practice Address - Phone:440-845-0022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
5605035OtherCIGNA
OH44584OtherWELLCARE
OH5605035OtherCIGNA
OHID02331Medicare PIN