Provider Demographics
NPI:1740490747
Name:SUN MEDICAL & MOBILITY EQUIPMENT
Entity type:Organization
Organization Name:SUN MEDICAL & MOBILITY EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:V
Authorized Official - Last Name:VALAINIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-645-8008
Mailing Address - Street 1:6412 STORMY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-5328
Mailing Address - Country:US
Mailing Address - Phone:702-645-8008
Mailing Address - Fax:702-448-5559
Practice Address - Street 1:6412 STORMY CREEK RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-5328
Practice Address - Country:US
Practice Address - Phone:702-645-8008
Practice Address - Fax:702-448-5559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMW00024332B00000X, 332BC3200X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
1229360001Medicare NSC