MEDICARE: SUNSHINE SURGICAL

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	6000005639	PA

General Provider Information

NPI Number	:	1922092725
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSHINE SURGICAL

Provider Business Mailing Address
First Line	:	6546 TORRESDALE AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19135-2822
Country	:	US
Telephone Number	:	215-624-1998
Fax Number	:	215-624-2105

Provider Business Practice Location Address
First Line	:	6546 TORRESDALE AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19135-2822
Country	:	US
Telephone Number	:	215-624-1998
Fax Number	:	215-624-2105

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. JANE E DAMIAN
Credential	:
Telephone Number	:	215-624-1998

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	08/22/2020

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Directions to “SUNSHINE SURGICAL ” Practice Location

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