Provider Demographics
NPI:1184847196
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:VP OF FINANCE & ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSE
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 1:606 DENBIGH BLVD
Practice Address - Street 2:SUITE 105-B
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23608-4413
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:2007-04-10
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1184847196Medicaid
VA552495OtherSOUTHERN HEALTH
VA2165795OtherONENET PPO
MD419630OtherCARE FIRST
VAP00600120OtherRAILROAD MEDICARE
MD520537OtherCARE FIRST
VA8597001OtherCARE FIRST
VA2165795OtherMAMSI
VA2165795OtherOPTIMUM CHOICE
VA364504OtherANTHEM BLUE CROSS
MD85TZDIOtherCARE FIRST
VA8597002OtherCARE FIRST
VA2165795OtherMDIPA
MD419630OtherCARE FIRST
VA2165795OtherOPTIMUM CHOICE