Provider Demographics
NPI:1295836179
Name:SOUTHWEST CLEVELAND SLEEP CENTER, INC
Entity Type:Organization
Organization Name:SOUTHWEST CLEVELAND SLEEP CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:MANSOOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-239-7533
Mailing Address - Street 1:17900 JEFFERSON PARK RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3437
Mailing Address - Country:US
Mailing Address - Phone:440-239-7533
Mailing Address - Fax:440-239-2585
Practice Address - Street 1:29160 CENTER RIDGE RD
Practice Address - Street 2:SUITE S
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5225
Practice Address - Country:US
Practice Address - Phone:440-250-9194
Practice Address - Fax:440-250-0060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000287200OtherANTHEM
OH22653OtherQUALCHOICE
OH=========007OtherMEDICAL MUTUAL OF OHIO
OH000000287200OtherANTHEM
OHP00095046Medicare ID - Type UnspecifiedRAILROAD MEDICARE
OHSOID01911Medicare PIN