Provider Demographics
NPI:1588611677
Name:SUNSET IMAGING, LLC
Entity Type:Organization
Organization Name:SUNSET IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEMIR
Authorized Official - Middle Name:EROL
Authorized Official - Last Name:BASTUG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-575-6552
Mailing Address - Street 1:PO BOX 7717
Mailing Address - Street 2:
Mailing Address - City:OCEAN ISLE BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28469-1717
Mailing Address - Country:US
Mailing Address - Phone:910-575-6552
Mailing Address - Fax:910-575-6690
Practice Address - Street 1:850 SUNSET BLVD N
Practice Address - Street 2:
Practice Address - City:SUNSET BEACH
Practice Address - State:NC
Practice Address - Zip Code:28468-4262
Practice Address - Country:US
Practice Address - Phone:910-575-6552
Practice Address - Fax:910-575-6690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC017M3OtherBCBS
2881826AOtherMEDICARE SECOND SITE
NC5902630Medicaid
2881826AOtherMEDICARE SECOND SITE