MEDICARE: SUNSET COMMUNITY HEALTH CENTER INC

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
1	3336C0002X	Clinic Pharmacy	4424	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0353348	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376502054
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSET COMMUNITY HEALTH CENTER INC

Provider Business Mailing Address
First Line	:	2060 W 24TH ST
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-6123
Country	:	US
Telephone Number	:	928-819-8941
Fax Number	:	928-376-6606

Provider Business Practice Location Address
First Line	:	815 E CESAR CHAVEZ BLVD
Second Line	:
City	:	SAN LUIS
State	:	AZ
Zip	:	85349
Country	:	US
Telephone Number	:	928-373-5757
Fax Number	:	928-627-2768

Authorized Official
Title or Position	:	CEO
Name	:	DAVID ROGERS
Credential	:	MBA
Telephone Number	:	928-819-8999

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	10/12/2020

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Directions to “SUNSET COMMUNITY HEALTH CENTER INC ” Practice Location

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