Provider Demographics
NPI:1003933466
Name:SUNCITY MEDICAL
Entity Type:Organization
Organization Name:SUNCITY MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:N
Authorized Official - Last Name:ONONYE
Authorized Official - Suffix:SR
Authorized Official - Credentials:MSW,SOCIAL WORKER
Authorized Official - Phone:313-657-6127
Mailing Address - Street 1:202 EAST MC DONWELL SUITE 133
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004
Mailing Address - Country:US
Mailing Address - Phone:602-252-1048
Mailing Address - Fax:602-253-2315
Practice Address - Street 1:202 EAST MC DONWELL SUITE 133
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004
Practice Address - Country:US
Practice Address - Phone:602-252-1048
Practice Address - Fax:602-253-2315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZL1283620-5332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies