Provider Demographics
NPI:1376723320
Name:UNIVERSITY SLEEP MEDICINE LLC
Entity Type:Organization
Organization Name:UNIVERSITY SLEEP MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ESKENDER
Authorized Official - Middle Name:
Authorized Official - Last Name:GETACHEW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-854-0300
Mailing Address - Street 1:9039 ANTARES AVE
Mailing Address - Street 2:STE A1 AND B1
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43240-4067
Mailing Address - Country:US
Mailing Address - Phone:614-854-0300
Mailing Address - Fax:614-854-0302
Practice Address - Street 1:1050 KINGSMILL PKWY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-1143
Practice Address - Country:US
Practice Address - Phone:614-854-0300
Practice Address - Fax:614-854-0302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0098377Medicaid
OH9372521Medicare PIN
OHDN4153Medicare PIN