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General NPI Number Information
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NPI Number | 1336607746
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Entity Type | Organization
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Legal Business Name | SUNLIGHT MEDICAL SERVICES PLLC
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Dates
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Enumeration Date | 03/05/2019
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Last Update Date | 06/17/2021
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Provider Practice Location Address
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Address Line | 5750 W THUNDERBIRD RD SUITE F-640
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City | GLENDALE
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State | AZ
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Zip | 85306
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Country | US
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Telephone | 480-300-6065
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Fax | 855-923-0899
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Provider Business Mailing Address
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Address Line | 5750 W THUNDERBIRD RD SUITE F-640
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City | GLENDALE
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State | AZ
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Zip | 85306
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Country | US
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Telephone | 480-300-6065
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Fax | 855-923-0899
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | VICKY DRAMARETSKA
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Credential | PA-C
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Telephone | 480-300-6065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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Taxonomy #3
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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Taxonomy #4
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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Taxonomy #5
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Taxonomy Code | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number |
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