Provider Demographics
NPI:1477500726
Name:SLEEP CENTERS OF EASTGATE LLC
Entity Type:Organization
Organization Name:SLEEP CENTERS OF EASTGATE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:SNIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-459-7750
Mailing Address - Street 1:4355 FERGUSON DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-5136
Mailing Address - Country:US
Mailing Address - Phone:513-753-4100
Mailing Address - Fax:513-753-8602
Practice Address - Street 1:4355 FERGUSON DR
Practice Address - Street 2:SUITE 100
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-5136
Practice Address - Country:US
Practice Address - Phone:513-753-4100
Practice Address - Fax:513-753-8602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2520909Medicaid
OH9344911Medicare ID - Type UnspecifiedMEDICARE PROVIDER #