Provider Demographics
NPI:1245495019
Name:BLUEGRASS SLEEP DISORDERS CENTER
Entity type:Organization
Organization Name:BLUEGRASS SLEEP DISORDERS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-885-4890
Mailing Address - Street 1:101 W 18TH ST
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-1960
Mailing Address - Country:US
Mailing Address - Phone:270-885-4890
Mailing Address - Fax:270-885-1759
Practice Address - Street 1:101 W 18TH ST
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-1960
Practice Address - Country:US
Practice Address - Phone:270-885-4890
Practice Address - Fax:270-885-1759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic