Healthcare Provider Details

I. General information

NPI: 1922122092
Provider Name (Legal Business Name): SUNTUN MEDICAL TRANSPORTATION INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4075 E 79TH ST
CLEVELAND OH
44105-5109
US

IV. Provider business mailing address

4075 E 79TH ST
CLEVELAND OH
44105-5109
US

V. Phone/Fax

Practice location:
  • Phone: 216-641-6113
  • Fax: 216-441-3425
Mailing address:
  • Phone: 216-641-6113
  • Fax: 216-441-3425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateOH

VIII. Authorized Official

Name: MR. ADEMOLA OLATUNJI GBADEGESIN
Title or Position: OWNER
Credential:
Phone: 216-287-2201