Provider Demographics
NPI:1942216601
Name:SLEEP TELEMEDICINE SERVICES, INC
Entity Type:Organization
Organization Name:SLEEP TELEMEDICINE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:C
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-657-1920
Mailing Address - Street 1:908 W TERRELL AVE N
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-3034
Mailing Address - Country:US
Mailing Address - Phone:800-657-1920
Mailing Address - Fax:817-820-0430
Practice Address - Street 1:910 W TERRELL AVE N
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-3034
Practice Address - Country:US
Practice Address - Phone:800-657-1920
Practice Address - Fax:817-820-0430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP00452376OtherRR MEDICARE KY
KYP00995634OtherRR MEDICARE KY
FLP01268066OtherRR MEDICARE FL
NVP01273982OtherRR MEDICARE NV
NYP00098084OtherRR MEDICARE NY
OH2369093Medicaid
NYCC6204Medicare PIN
MO0093042Medicare PIN
NVV32706Medicare PIN
FLP01268066OtherRR MEDICARE FL
KYP00452376OtherRR MEDICARE KY
OH2369093Medicaid