Provider Demographics
NPI:1336694397
Name:SUN CITY HOME IMPROVEMENTS
Entity Type:Organization
Organization Name:SUN CITY HOME IMPROVEMENTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA ROSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-588-5640
Mailing Address - Street 1:14980 DOE LN
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-9078
Mailing Address - Country:US
Mailing Address - Phone:915-613-8454
Mailing Address - Fax:
Practice Address - Street 1:11394 JAMES WATT DR
Practice Address - Street 2:STE 208
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-6436
Practice Address - Country:US
Practice Address - Phone:915-613-8454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-19
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty