Provider Demographics
NPI:1326356387
Name:ULISSES ACUNA
Entity Type:Organization
Organization Name:ULISSES ACUNA
Other - Org Name:SUN CITY MEDICAL SUPPLY II
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ULISSES
Authorized Official - Middle Name:
Authorized Official - Last Name:ACUNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-590-7008
Mailing Address - Street 1:1530 GOODYEAR DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-6062
Mailing Address - Country:US
Mailing Address - Phone:915-590-7008
Mailing Address - Fax:915-590-7009
Practice Address - Street 1:1530 GOODYEAR DR STE A1
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-6037
Practice Address - Country:US
Practice Address - Phone:915-533-4466
Practice Address - Fax:915-533-4471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-23
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX335496101Medicaid