Healthcare Provider Details

I. General information

NPI: 1548472475
Provider Name (Legal Business Name): SUN LIFE FAMILY HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44572 WEST BOWLIN ROAD
MARICOPA AZ
85139
US

IV. Provider business mailing address

PO BOX 96395
PHOENIX AZ
85072-6395
US

V. Phone/Fax

Practice location:
  • Phone: 520-568-2245
  • Fax: 520-568-2316
Mailing address:
  • Phone: 520-836-3446
  • Fax: 520-836-8807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: JESSICA COVEY
Title or Position: CFO
Credential:
Phone: 520-836-3446