Provider Demographics
NPI:1902070923
Name:SLEEP SERVICES OF AMERICA
Entity Type:Organization
Organization Name:SLEEP SERVICES OF AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:MATHIAS
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:410-760-6990
Mailing Address - Street 1:890 AIRPORT PARK RD
Mailing Address - Street 2:SUITE 119
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-2559
Mailing Address - Country:US
Mailing Address - Phone:410-760-6990
Mailing Address - Fax:410-760-9497
Practice Address - Street 1:42-B MARKET SQUARE RD
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265
Practice Address - Country:US
Practice Address - Phone:404-892-0308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA007058261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic