MEDICARE: SUNSHINE DME SUPPLY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1477377463
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSHINE DME SUPPLY LLC

Provider Business Mailing Address
First Line	:	1001 W EULESS BLVD STE 413
Second Line	:
City	:	EULESS
State	:	TX
Zip	:	76040-5034
Country	:	US
Telephone Number	:	682-434-2721
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 W EULESS BLVD STE 413
Second Line	:
City	:	EULESS
State	:	TX
Zip	:	76040-5034
Country	:	US
Telephone Number	:	214-909-6063
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NIKA VATSADZE
Credential	:
Telephone Number	:	682-434-2721

Provider Enumeration Date	:	11/14/2024
Last Update Date	:	09/17/2025

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Directions to “SUNSHINE DME SUPPLY LLC ” Practice Location

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