Provider Demographics
NPI:1174575146
Name:OHIO SLEEP DISORDERS
Entity type:Organization
Organization Name:OHIO SLEEP DISORDERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-376-1902
Mailing Address - Street 1:PO BOX 1737
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44309-1737
Mailing Address - Country:US
Mailing Address - Phone:888-328-4472
Mailing Address - Fax:330-493-7123
Practice Address - Street 1:3985 MEDINA RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-5968
Practice Address - Country:US
Practice Address - Phone:888-328-4472
Practice Address - Fax:330-493-7123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2352109Medicaid
OHNE9354021Medicare ID - Type Unspecified