Provider Demographics
NPI:1942273354
Name:CAROLINA SLEEP MEDICINE, INC.
Entity Type:Organization
Organization Name:CAROLINA SLEEP MEDICINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND C.E.O.
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:RAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-993-8448
Mailing Address - Street 1:495 ARBOR HILL ROAD
Mailing Address - Street 2:SUITE G
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284
Mailing Address - Country:US
Mailing Address - Phone:336-993-8448
Mailing Address - Fax:336-993-8488
Practice Address - Street 1:610 N FAYETTEVILLE ST
Practice Address - Street 2:SUITE 102
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-4670
Practice Address - Country:US
Practice Address - Phone:336-993-8448
Practice Address - Fax:336-993-8488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-08
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QS1200X
NC001136390332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7704203Medicaid
NC89012WYMedicaid
NC5250100003Medicare NSC
NC89012WYMedicaid