Provider Demographics
NPI:1780944249
Name:CAPITAL CITY SLEEP CENTER LLC
Entity type:Organization
Organization Name:CAPITAL CITY SLEEP CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MULAI
Authorized Official - Middle Name:TEKLU
Authorized Official - Last Name:YOHANNES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-279-7342
Mailing Address - Street 1:1310 SOUTHERN AVE SE
Mailing Address - Street 2:RM 4436
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-4623
Mailing Address - Country:US
Mailing Address - Phone:202-279-7342
Mailing Address - Fax:202-574-5391
Practice Address - Street 1:1310 SOUTHERN AVE SE
Practice Address - Street 2:RM 4436
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4623
Practice Address - Country:US
Practice Address - Phone:202-279-7342
Practice Address - Fax:202-574-5391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-17
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder DiagnosticGroup - Multi-Specialty