Provider Demographics
NPI:1427377969
Name:SUNRAY MEDICAL & SURGICAL SUPPLIES, INC.
Entity Type:Organization
Organization Name:SUNRAY MEDICAL & SURGICAL SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VISWANADHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GADEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:609-395-7030
Mailing Address - Street 1:4 RESEARCH WAY UNIT 4
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-6801
Mailing Address - Country:US
Mailing Address - Phone:609-395-4703
Mailing Address - Fax:
Practice Address - Street 1:4 RESEARCH WAY UNIT 4
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NJ
Practice Address - Zip Code:08831-6801
Practice Address - Country:US
Practice Address - Phone:609-395-4703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-24
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6493670001Medicare NSC