Provider Demographics
NPI:1669015632
Name:SLEEP INSTITUTE OF THE UPSTATE LLC
Entity Type:Organization
Organization Name:SLEEP INSTITUTE OF THE UPSTATE LLC
Other - Org Name:GREENVILLE SLEEP CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAVINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:731-695-1754
Mailing Address - Street 1:103B REGENCY COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-5210
Mailing Address - Country:US
Mailing Address - Phone:864-334-7090
Mailing Address - Fax:864-627-9301
Practice Address - Street 1:103B REGENCY COMMONS DR
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-5210
Practice Address - Country:US
Practice Address - Phone:864-334-7090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-23
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty