Provider Demographics
NPI:1043268808
Name:MIDWEST SLEEP INSTITUTE
Entity type:Organization
Organization Name:MIDWEST SLEEP INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SALES VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-235-2326
Mailing Address - Street 1:L-2816
Mailing Address - Street 2:HUNTINGTON L/B
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43260-0001
Mailing Address - Country:US
Mailing Address - Phone:614-235-2326
Mailing Address - Fax:614-235-5194
Practice Address - Street 1:11590 N MERIDIAN ST
Practice Address - Street 2:SUITE 400
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-6954
Practice Address - Country:US
Practice Address - Phone:614-235-2326
Practice Address - Fax:614-235-5194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN233010Medicare ID - Type UnspecifiedMEDICARE