Healthcare Provider Details

I. General information

NPI: 1376502054
Provider Name (Legal Business Name): SUNSET COMMUNITY HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 10/12/2020
Certification Date: 10/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 E CESAR CHAVEZ BLVD
SAN LUIS AZ
85349
US

IV. Provider business mailing address

2060 W 24TH ST
YUMA AZ
85364-6123
US

V. Phone/Fax

Practice location:
  • Phone: 928-373-5757
  • Fax: 928-627-2768
Mailing address:
  • Phone: 928-819-8941
  • Fax: 928-376-6606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number4424
License Number StateAZ

VIII. Authorized Official

Name: DAVID ROGERS
Title or Position: CEO
Credential: MBA
Phone: 928-819-8999