SUN LIFE FAMILY HEALTH CENTER INC NPI 1417286568

NPI Information

NPI: 1417286568
Provider Name: SUN LIFE FAMILY HEALTH CENTER, INC

Doing Business As: SUN LIFE CENTER FOR CHILDREN

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 03D2070556

Address:
1856 E FLORENCE BLVD
CASA GRANDE, AZ
ZIP 85122
Phone: (520) 381-0380
Get Directions

SUN LIFE FAMILY HEALTH CENTER, INC is a federally qualified health center (fqhc) clinic center in Casa Grande, AZ. SUN LIFE FAMILY HEALTH CENTER, INC NPI is 1417286568. The provider is registered as an organization entity type.
The provider Is Doing Business As Sun Life Center For Children.

The provider's business location address is:

1856 E FLORENCE BLVD
CASA GRANDE, AZ
ZIP 85122-303
Phone: (520) 381-0380
Fax: (520) 836-1826

The provider's authorized official is Travis Robinette .
The authorized official title is Chief Executive Officer and has the following contact phone number (520) 836-3446.

The CLIA number assigned to this NPI record is 03D2070556 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/21/2009 and was last updated on 8/3/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	OTC4752	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	AZ13154	MEDICAID	ARIZONA
2	03-1881	OTHER	ARIZONA	MEDICARE
3	ZFQ31815	OTHER	ARIZONA	MEDICARE
4	BL-09-55271	OTHER	ARIZONA	CITY BUSINESS LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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