=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396202677
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SUNSHINE EXPRESS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/22/2019
-----------------------------------------------------
Last Update Date | 11/16/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 276 WILDFLOWER LN
-----------------------------------------------------
City | HILLSBOROUGH
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08844-4873
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-265-0164
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 276 WILDFLOWER LN
-----------------------------------------------------
City | HILLSBOROUGH
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08844-4873
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-265-0164
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | UHUNOMA SUNNY EWERE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 908-265-0164
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------