Provider Demographics
NPI:1497730394
Name:REM DIAGNOSTICS, INC.
Entity Type:Organization
Organization Name:REM DIAGNOSTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:
Authorized Official - Last Name:SWOBODA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-785-0126
Mailing Address - Street 1:PO BOX 1708
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93406-1708
Mailing Address - Country:US
Mailing Address - Phone:805-785-0126
Mailing Address - Fax:805-784-0127
Practice Address - Street 1:1329 BROAD ST STE C
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-1928
Practice Address - Country:US
Practice Address - Phone:805-785-0126
Practice Address - Fax:805-785-0127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-13
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATG261Medicare PIN
CATG261Medicare PIN
CACMSP 1052OtherCMSP