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General NPI Number Information
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NPI Number | 1033215793
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Entity Type | Organization
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Legal Business Name | SUNSHINE HEALTH CARE, INC
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 03/05/2008
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Provider Practice Location Address
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Address Line | 1677 HIGHWAY 9 N
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City | PONTOTOC
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State | MS
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Zip | 38863-9279
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Country | US
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Telephone | 662-489-1189
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Fax |
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Provider Business Mailing Address
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Address Line | 1677 HIGHWAY 9 N
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City | PONTOTOC
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State | MS
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Zip | 38863-9279
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Country | US
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Telephone | 662-489-1189
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. ERIC WAYNE HOLLAND
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Credential | N.H.A.
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Telephone | 662-489-1189
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 118
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License Number State | MS
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