Provider Demographics
NPI:1710179262
Name:CENTRAL VIRGINIA SLEEP DISORDERS CENTER, PLLC
Entity Type:Organization
Organization Name:CENTRAL VIRGINIA SLEEP DISORDERS CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PH.D., NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARTSOOK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, APRN, BC
Authorized Official - Phone:804-270-6811
Mailing Address - Street 1:1601 ROLLING HILLS DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-5011
Mailing Address - Country:US
Mailing Address - Phone:804-282-5555
Mailing Address - Fax:804-270-7840
Practice Address - Street 1:1601 ROLLING HILLS DR
Practice Address - Street 2:SUITE 103
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-5011
Practice Address - Country:US
Practice Address - Phone:804-282-5555
Practice Address - Fax:804-270-7840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAS1609496261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic