Provider Demographics
NPI:1972709483
Name:SLEEP SERVICES OF AMERICA INC.
Entity Type:Organization
Organization Name:SLEEP SERVICES OF AMERICA INC.
Other - Org Name:SOUTHERN SLEEP TECHNOLOGIES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:S
Authorized Official - Last Name:MELLOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-527-5970
Mailing Address - Street 1:430 WOODRUFF RD
Mailing Address - Street 2:SUITE 450
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-3495
Mailing Address - Country:US
Mailing Address - Phone:864-527-5970
Mailing Address - Fax:864-527-5971
Practice Address - Street 1:4524 FORSYTH RD
Practice Address - Street 2:SUITE 205
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-4545
Practice Address - Country:US
Practice Address - Phone:478-757-0759
Practice Address - Fax:478-757-0769
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDBRIDGE ACQUISITION CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-22
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1186230002Medicare NSC