Provider Demographics
NPI:1134491129
Name:SUNRISE MEDICATIONS INC
Entity Type:Organization
Organization Name:SUNRISE MEDICATIONS INC
Other - Org Name:MEDI-HOME INFUSION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JEFFCOAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-957-0500
Mailing Address - Street 1:PO BOX 1928
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29071-1928
Mailing Address - Country:US
Mailing Address - Phone:803-957-0500
Mailing Address - Fax:888-342-6190
Practice Address - Street 1:2 PALMETTO WOOD PKWY
Practice Address - Street 2:STE 102
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-2881
Practice Address - Country:US
Practice Address - Phone:800-672-6334
Practice Address - Fax:803-957-2541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-06
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC152013336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDE3473Medicaid
SC715201Medicaid
SCDE3473Medicaid
FM3012084OtherDEA REGISTRATION NUMBER
SCDE3473Medicaid