Provider Demographics
NPI:1174544118
Name:SLEEP NETWORK OF WEST VIRGINIA
Entity type:Organization
Organization Name:SLEEP NETWORK OF WEST VIRGINIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:DRAGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-535-9282
Mailing Address - Street 1:3450 W CENTRAL AVE
Mailing Address - Street 2:SUITE 118
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1416
Mailing Address - Country:US
Mailing Address - Phone:419-535-9282
Mailing Address - Fax:419-535-9443
Practice Address - Street 1:14 E GRAFTON RD
Practice Address - Street 2:SUITE D
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-0067
Practice Address - Country:US
Practice Address - Phone:304-333-0227
Practice Address - Fax:304-333-0261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory