Provider Demographics
NPI:1740234905
Name:SLEEPEZ DIAGNOSTIC CENTER INC.
Entity Type:Organization
Organization Name:SLEEPEZ DIAGNOSTIC CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAQUEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROTHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-375-7735
Mailing Address - Street 1:1957 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-3109
Mailing Address - Country:US
Mailing Address - Phone:540-375-7735
Mailing Address - Fax:
Practice Address - Street 1:1957 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-3109
Practice Address - Country:US
Practice Address - Phone:540-375-7735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101230727261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10237467Medicaid
VA188389OtherANTHEM
VA10242983Medicaid