Provider Demographics
NPI:1942975933
Name:SUN MEDICAL EQUIPMENT INC
Entity Type:Organization
Organization Name:SUN MEDICAL EQUIPMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SOLOMON
Authorized Official - Middle Name:
Authorized Official - Last Name:YAQOOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-307-8090
Mailing Address - Street 1:1915 W REDLANDS BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-8050
Mailing Address - Country:US
Mailing Address - Phone:909-307-8090
Mailing Address - Fax:909-307-8099
Practice Address - Street 1:635 HIGHLAND SPRINGS AVE
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223-2540
Practice Address - Country:US
Practice Address - Phone:951-888-3007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUN MEDICAL EQUIPMENT INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies