Provider Demographics
NPI:1528010501
Name:OHIO SLEEP DISORDERS CENTERS, LLC
Entity Type:Organization
Organization Name:OHIO SLEEP DISORDERS CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
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:330-899-5730
Mailing Address - Street 1:PO BOX 1737
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44309-1737
Mailing Address - Country:US
Mailing Address - Phone:866-455-6693
Mailing Address - Fax:330-493-7123
Practice Address - Street 1:1700 BOETTLER RD
Practice Address - Street 2:SUITE 250
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-7792
Practice Address - Country:US
Practice Address - Phone:330-899-5730
Practice Address - Fax:330-899-0522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2352109Medicaid
OH2352109Medicaid
OHOHID00721Medicare PIN