Provider Demographics
NPI:1194828723
Name:REST ASSURED SLEEP CENTERS, LLC
Entity Type:Organization
Organization Name:REST ASSURED SLEEP CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:JUMOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINNAGBE
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:410-897-8445
Mailing Address - Street 1:2629 RIVA RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7428
Mailing Address - Country:US
Mailing Address - Phone:410-897-8445
Mailing Address - Fax:410-895-8448
Practice Address - Street 1:2401 BRANDERMILL BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:GAMBRILLS
Practice Address - State:MD
Practice Address - Zip Code:21054-1690
Practice Address - Country:US
Practice Address - Phone:410-897-8445
Practice Address - Fax:866-429-2689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2345332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDFMS2005Medicare ID - Type UnspecifiedIDTF
MDY17549Medicare UPIN