Provider Demographics
NPI:1265688394
Name:DIAGNOSTIC SLEEP MED CENTER, LLC
Entity Type:Organization
Organization Name:DIAGNOSTIC SLEEP MED CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF EAST COAST OPERATION
Authorized Official - Prefix:
Authorized Official - First Name:MERRI
Authorized Official - Middle Name:LINETTE
Authorized Official - Last Name:BURKHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:RPST
Authorized Official - Phone:814-335-4204
Mailing Address - Street 1:121 GRAND AVE
Mailing Address - Street 2:PO BOX 1169
Mailing Address - City:MARS
Mailing Address - State:PA
Mailing Address - Zip Code:16046
Mailing Address - Country:US
Mailing Address - Phone:724-625-0900
Mailing Address - Fax:724-625-0901
Practice Address - Street 1:121 GRAND AVE
Practice Address - Street 2:
Practice Address - City:MARS
Practice Address - State:PA
Practice Address - Zip Code:16046
Practice Address - Country:US
Practice Address - Phone:724-625-0900
Practice Address - Fax:724-625-0901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory