Provider Demographics
NPI:1063975787
Name:SUNNY DME, LLC
Entity type:Organization
Organization Name:SUNNY DME, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEK
Authorized Official - Middle Name:
Authorized Official - Last Name:CRNOGORAC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-244-7153
Mailing Address - Street 1:3070 RIVERSIDE DR STE 125
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-2557
Mailing Address - Country:US
Mailing Address - Phone:888-244-7153
Mailing Address - Fax:833-219-0398
Practice Address - Street 1:3070 RIVERSIDE DR STE 125
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2557
Practice Address - Country:US
Practice Address - Phone:888-244-7153
Practice Address - Fax:833-219-0398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-09
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0371376Medicaid