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NPI Code Detail

MEDICARE: SUNBRIDGE DUNBAR HEALTH CARE LLC

MEDICARE: SUNBRIDGE DUNBAR HEALTH CARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1313M00000XNursing Facility/Intermediate Care Facility82WV
2314000000XSkilled Nursing Facility82WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000391983OTHERWVFEDERAL BCBS
2000391983OTHERSCBCBS OF COLUMBIA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4000391983OTHERKYANTHEM BCBS

General Provider Information

NPI Number : 1114974649
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUNBRIDGE DUNBAR HEALTH CARE LLC
Provider Business Mailing Address
First Line : 101 SUN AVE NE
Second Line : COMPLIANCE DEPARTMENT
City : ALBUQUERQUE
State : NM
Zip : 87109-4373
Country : US
Telephone Number : 505-468-5604
Fax Number : 505-468-4681
Provider Business Practice Location Address
First Line : 501 CALDWELL LANE
Second Line :
City : DUNBAR
State : WV
Zip : 25064-2026
Country : US
Telephone Number : 304-744-4761
Fax Number : 304-744-5762
Authorized Official
Title or Position : ASSISTANT SECRETARY
Name : MICHAEL T. BERG
Credential :
Telephone Number : 505-468-4752
Provider Enumeration Date : 05/29/2006
Last Update Date : 08/28/2025

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Directions to “SUNBRIDGE DUNBAR HEALTH CARE LLC ” Practice Location

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