Provider Demographics
NPI:1639538333
Name:SANDROG INTERNATIONAL COMMERCE, LLC
Entity Type:Organization
Organization Name:SANDROG INTERNATIONAL COMMERCE, LLC
Other - Org Name:SANDROG MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OLUDARE
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUNDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-591-9893
Mailing Address - Street 1:2000 N 20TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-3934
Mailing Address - Country:US
Mailing Address - Phone:804-505-0010
Mailing Address - Fax:
Practice Address - Street 1:1518 WILLOW LAWN DR FL 3
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3419
Practice Address - Country:US
Practice Address - Phone:804-505-0010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA10F001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies