Provider Demographics
NPI:1407849771
Name:SLEEP MEDICINE WV, INC.
Entity Type:Organization
Organization Name:SLEEP MEDICINE WV, INC.
Other - Org Name:CHARLESTON SLEEP SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:LO'AY
Authorized Official - Middle Name:
Authorized Official - Last Name:AL-ASADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-925-7676
Mailing Address - Street 1:301 49TH ST SE
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1909
Mailing Address - Country:US
Mailing Address - Phone:304-269-5751
Mailing Address - Fax:304-269-5617
Practice Address - Street 1:301 49TH ST SE
Practice Address - Street 2:SUITE B
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1909
Practice Address - Country:US
Practice Address - Phone:304-269-5751
Practice Address - Fax:304-269-5617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1430174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV4000227000Medicaid
WV290103OtherMAMSI GROUP NO.
WV290103OtherMAMSI GROUP NO.
WVSL9308481Medicare ID - Type UnspecifiedGROUP MEDICARE NO.