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General NPI Number Information
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NPI Number | 1518344068
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Entity Type | Organization
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Legal Business Name | SUNRISE MEDICAL COMPANY LLC
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Dates
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Enumeration Date | 05/05/2015
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Last Update Date | 05/05/2015
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Provider Practice Location Address
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Address Line | 4500 HUGH HOWELL RD SUITE 110
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City | TUCKER
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State | GA
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Zip | 30084-4723
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Country | US
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Telephone | 310-293-1137
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Fax |
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Provider Business Mailing Address
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Address Line | 3302 PRESERVATION CIR
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City | LILBURN
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State | GA
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Zip | 30047-2079
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. HILARY NWOSU
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Credential | MD
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Telephone | 310-293-1137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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