Provider Demographics
NPI:1487666095
Name:SLEEPMED INC
Entity Type:Organization
Organization Name:SLEEPMED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:R
Authorized Official - Last Name:IBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-536-7400
Mailing Address - Street 1:60 CHASTAIN BLVD
Mailing Address - Street 2:SUITE 66
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144
Mailing Address - Country:US
Mailing Address - Phone:978-536-7400
Mailing Address - Fax:978-535-9757
Practice Address - Street 1:102 CORPORATE SQ
Practice Address - Street 2:SUITE G & H
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-4225
Practice Address - Country:US
Practice Address - Phone:800-770-5874
Practice Address - Fax:478-745-5125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
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
2860017OtherAETNA
43490832OtherUNITED HEALTH CARE
905532OtherBLUE CROSS/BLUE SHIELD
905532OtherBLUE CROSS/BLUE SHIELD