Healthcare Provider Details

I. General information

NPI: 1396240149
Provider Name (Legal Business Name): SUNSET COMMUNITY HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2018
Last Update Date: 02/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 S AVENUE B
YUMA AZ
85364-2749
US

IV. Provider business mailing address

2060 W 24TH ST
YUMA AZ
85364-6123
US

V. Phone/Fax

Practice location:
  • Phone: 928-819-8920
  • Fax: 928-376-6606
Mailing address:
  • Phone: 928-819-8802
  • Fax: 928-539-5579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License NumberY007354
License Number StateAZ

VIII. Authorized Official

Name: DAVID D ROGERS
Title or Position: CEO
Credential:
Phone: 928-819-8802