Provider Demographics
NPI:1790815025
Name:SLEEPMED HAMPTON ROADS LLC
Entity Type:Organization
Organization Name:SLEEPMED HAMPTON ROADS LLC
Other - Org Name:SLEEPMED HAMPTON ROADS LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEMANG
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-686-8594
Mailing Address - Street 1:PO BOX 3808
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23663-3808
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4480 HOLLAND OFFICE PARK
Practice Address - Street 2:SUITE 225-B
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452
Practice Address - Country:US
Practice Address - Phone:978-536-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD419630OtherCARE FIRST
VA8597002OtherCARE FIRST
VA2165795OtherONENET PPO
MD85TZDIOtherCARE FIRST
VA304507OtherANTHEM BCBS
VAP00600120OtherRAILROAD MEDICARE
VA2165795OtherMAMSI
VA2165795OtherOPTIMUM CHOICE
VA1790815025Medicaid
MD520537OtherCARE FIRST
VA216795OtherMDIPA
VA8597001OtherCARE FIRST
VA=========OtherTRICARE
VAFVS014Medicare PIN