Provider Demographics
NPI:1194905026
Name:SUNRISE MEDICAL EQUIPMENT & OXYGEN INC
Entity type:Organization
Organization Name:SUNRISE MEDICAL EQUIPMENT & OXYGEN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:PHILLIP
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-749-4420
Mailing Address - Street 1:10358 NW 55TH ST
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-8731
Mailing Address - Country:US
Mailing Address - Phone:954-749-4420
Mailing Address - Fax:954-749-4417
Practice Address - Street 1:10358 NW 55TH ST
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-8731
Practice Address - Country:US
Practice Address - Phone:954-749-4420
Practice Address - Fax:954-749-4417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1360332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5191330001Medicare NSC