Healthcare Provider Details
I. General information
NPI: 1083604300
Provider Name (Legal Business Name): SUNMED MEDICAL SYSTEMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/27/2005
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
36 W ROUTE 70 SUITE 214
MARLTON NJ
08053-3024
US
IV. Provider business mailing address
36 WEST ROUTE 70 SUITE 214
MARLTON NJ
08053
US
V. Phone/Fax
- Phone: 800-714-7434
- Fax: 800-715-5422
- Phone: 800-714-7434
- Fax: 800-715-5422
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
WILLIAM
A
LOBOSCO
Title or Position: PRESIDENT
Credential:
Phone: 800-714-7434