Provider Demographics
NPI:1902451552
Name:SISU HEALTHCARE SOLUTIONS, INC.
Entity Type:Organization
Organization Name:SISU HEALTHCARE SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:E
Authorized Official - Last Name:ULM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-577-1617
Mailing Address - Street 1:914 S 52ND ST STE 110
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-9500
Mailing Address - Country:US
Mailing Address - Phone:480-999-4488
Mailing Address - Fax:480-999-4488
Practice Address - Street 1:914 S 52ND ST STE 110
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-9500
Practice Address - Country:US
Practice Address - Phone:480-999-4488
Practice Address - Fax:480-999-4488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-09
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No251F00000XAgenciesHome Infusion
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy