Provider Demographics
NPI:1184820151
Name:SLEEPMED HAMPTON ROADS LLC
Entity Type:Organization
Organization Name:SLEEPMED HAMPTON ROADS LLC
Other - Org Name:SLEEPMED OF HAMPTON ROADS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP-CFO
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:R
Authorized Official - Last Name:IBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-536-7400
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 1:154 BURNETTS WAY
Practice Address - Street 2:SUITE 101-A
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8366
Practice Address - Country:US
Practice Address - Phone:978-536-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2165795OtherMDIPA
VA344053OtherANTHEM BCBS
VA2165795OtherONENET PPO
MD419630OtherCARE FIRST
MD85TZDIOtherCARE FIRST
VA2165795OtherOPTIMUM CHOICE
MD520537OtherCARE FIRST
VA552495OtherSOUTHERN HEALTH
VA8597001OtherCARE FIRST
VAP00600120OtherRAILROAD MEDICARE
VA8597002OtherCARE FIRST
VA2165795OtherMAMSI
VA=========005OtherTRICARE
FVS021Medicare PIN