Provider Demographics
NPI:1598711095
Name:SUN MEDICAL LTD.
Entity Type:Organization
Organization Name:SUN MEDICAL LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:CRANWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-389-3800
Mailing Address - Street 1:1807 MURRY RD SW
Mailing Address - Street 2:SUITE A
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-1514
Mailing Address - Country:US
Mailing Address - Phone:540-389-3800
Mailing Address - Fax:540-389-8030
Practice Address - Street 1:1807 MURRY RD SW
Practice Address - Street 2:SUITE A
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-1514
Practice Address - Country:US
Practice Address - Phone:540-389-3800
Practice Address - Fax:540-389-8030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0206009236332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00910021OtherVIRGINIA PREMIER
VA009100121Medicaid
VA395990OtherANTHEM BCBS
VA395990OtherANTHEM BCBS