# GRAND LAKE SLEEP CENTER

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578654950
- **Authorized official:** DR. SARAT BABU KUCHIPUDI M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (419) 394-9992

## Contact information

- **Practice address:** 1040 HAGER ST, SAINT MARYS, OH 45885-2421
- **Practice address phone:** (419) 394-9992
- **Practice address fax:** (419) 394-9629
- **Mailing address:** 1040 HAGER ST, SAINT MARYS, OH 45885-2421
- **Mailing address phone:** (419) 394-9992
- **Mailing address fax:** (419) 394-9629

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1200X | Sleep Disorder Diagnostic Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/28/2006
- **Last updated:** 08/22/2020