Provider Demographics
NPI:1346274313
Name:OHIO SLEEP AND PULMONARY CENTER INC
Entity Type:Organization
Organization Name:OHIO SLEEP AND PULMONARY CENTER INC
Other - Org Name:OHIO SLEEP AND PULMONARY CENTER INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MARGOLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-836-5356
Mailing Address - Street 1:50 HILLSIDE CT
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45322-2745
Mailing Address - Country:US
Mailing Address - Phone:937-836-5356
Mailing Address - Fax:937-836-3420
Practice Address - Street 1:50 HILLSIDE CT
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45322-2745
Practice Address - Country:US
Practice Address - Phone:937-836-5356
Practice Address - Fax:937-836-3420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-6426-M207RP1001X
261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder DiagnosticGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2920709Medicaid
OH2920709Medicaid
OH5775000001Medicare NSC
OH9360481Medicare PIN