Provider Demographics
NPI:1902952542
Name:HEALTHY HEART SLEEP PROGRAMS INC
Entity Type:Organization
Organization Name:HEALTHY HEART SLEEP PROGRAMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:PAT
Authorized Official - Middle Name:
Authorized Official - Last Name:BOHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-586-5006
Mailing Address - Street 1:210 QUINCY AVE
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02302-2862
Mailing Address - Country:US
Mailing Address - Phone:508-586-5006
Mailing Address - Fax:178-196-3309
Practice Address - Street 1:210 QUINCY AVE
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-2862
Practice Address - Country:US
Practice Address - Phone:508-586-5006
Practice Address - Fax:178-196-3309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5578920001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA5578920001Medicare NSC