Organization
POLAND CENTER FOR SLEEP, LTD.
Active
Other names
Delta Center for Sleep, Ltd.
Organization subpart
No
Provider details
NPI number
Authorized official
MARK R. FORTUNATO ESQUIRE (MANAGING MEMBER)
(330) 757-3166
Entity
Organization
Contact information
Practice address
3296 STONES THROW AVE, POLAND, OH 44514-4213
(330) 757-3166
(330) 757-8202
Mailing address
3296 STONES THROW AVE, POLAND, OH 44514-4213
(330) 757-3166
(330) 757-8202
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000381168
ANTHEM
OH
05
—
2597971
—
OH
01
—
7204771
AETNA
OH
01
—
80314
UNICARE
OH
Enumeration date
12/13/2006
Last updated
08/22/2020
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