Healthcare Provider Details
I. General information
NPI: 1376359638
Provider Name (Legal Business Name): SUNMED MEDICAL SYSTEMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/10/2024
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2000 VAN NESS AVE
SAN FRANCISCO CA
94109-3023
US
IV. Provider business mailing address
36 ROUTE 70 W STE 214
MARLTON NJ
08053-3024
US
V. Phone/Fax
- Phone: 800-714-7434
- Fax:
- Phone: 800-714-7434
- Fax: 800-715-5422
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILLIAM
ANTHONY
LOBOSCO
Title or Position: PRESIDENT
Credential:
Phone: 856-552-6905