Provider Demographics
NPI:1508059601
Name:OHIO SLEEP DISORDERS CENTERS
Entity Type:Organization
Organization Name:OHIO SLEEP DISORDERS CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:C
Authorized Official - Last Name:RAFECAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-376-1902
Mailing Address - Street 1:130 W EXCHANGE ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44302-1701
Mailing Address - Country:US
Mailing Address - Phone:330-376-1902
Mailing Address - Fax:330-376-0482
Practice Address - Street 1:1 PARK WEST BLVD
Practice Address - Street 2:SUITE 370
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-4218
Practice Address - Country:US
Practice Address - Phone:330-376-1902
Practice Address - Fax:330-376-0482
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OHIO SLEEP DISORDERS CENTERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1002292261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic