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General NPI Number Information
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NPI Number | 1134306715
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Entity Type | Organization
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Legal Business Name | SUNRISE MEDICAL SUPPLY L.L.C.
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Dates
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Enumeration Date | 01/26/2008
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Last Update Date | 01/26/2008
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Provider Practice Location Address
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Address Line | 1305 VEGAS VALLEY DR STE F
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City | LAS VEGAS
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State | NV
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Zip | 89169-6217
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Country | US
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Telephone | 702-732-8999
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Fax | 702-360-6966
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Provider Business Mailing Address
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Address Line | 1305 VEGAS VALLEY DR STE F
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City | LAS VEGAS
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State | NV
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Zip | 89169-6217
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Country | US
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Telephone | 702-732-8999
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Fax | 702-360-6966
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Authorized Official
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Title or Position | MANAGER/PARTNER
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Name | MRS. ARMINE AMY MADZHARYAN
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Credential |
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Telephone | 702-403-4433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 2000148.424
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License Number State | NV
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