Provider Demographics
NPI:1184732190
Name:REST ASSURED SLEEP DISORDERS, INC
Entity type:Organization
Organization Name:REST ASSURED SLEEP DISORDERS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:JUMOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINNAGBE
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:410-897-8445
Mailing Address - Street 1:420 CHINQUAPIN ROUND RD
Mailing Address - Street 2:SUITE 2L
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-4006
Mailing Address - Country:US
Mailing Address - Phone:410-897-8445
Mailing Address - Fax:410-897-8448
Practice Address - Street 1:420 CHINQUAPIN ROUND RD
Practice Address - Street 2:SUITE 2L
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-4006
Practice Address - Country:US
Practice Address - Phone:410-897-8445
Practice Address - Fax:410-897-8448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2345332B00000X
261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDY17549Medicare UPIN