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NPI Code Detail

MEDICARE: SUNBRIDGE HEALTHCARE LLC

MEDICARE: SUNBRIDGE HEALTHCARE 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
1314000000XSkilled Nursing Facility16974AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760432652
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUNBRIDGE HEALTHCARE LLC
Provider Business Mailing Address
First Line : 1350 14TH AVE SE
Second Line :
City : DECATUR
State : AL
Zip : 35601-4364
Country : US
Telephone Number : 256-355-6911
Fax Number :
Provider Business Practice Location Address
First Line : 1350 14TH AVE SE
Second Line :
City : DECATUR
State : AL
Zip : 35601-4364
Country : US
Telephone Number : 256-355-6911
Fax Number :
Authorized Official
Title or Position : ASSISTANT SECRETARY
Name : MICHAEL T. BERG
Credential :
Telephone Number : 505-468-4752
Provider Enumeration Date : 05/11/2006
Last Update Date : 03/30/2017

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Directions to “SUNBRIDGE HEALTHCARE LLC ” Practice Location

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