Healthcare Provider Details

I. General information

NPI: 1326090887
Provider Name (Legal Business Name): SUN HEALTH CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 03/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13632 N 99TH AVE
SUN CITY AZ
85351-2861
US

IV. Provider business mailing address

PO BOX 1278 ATTN MINDY OGDEN
SUN CITY AZ
85372-1278
US

V. Phone/Fax

Practice location:
  • Phone: 623-876-4999
  • Fax: 623-876-4960
Mailing address:
  • Phone: 623-544-5075
  • Fax: 623-544-5093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM T. SELLNER
Title or Position: VP, CFO
Credential:
Phone: 623-876-6616