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General NPI Number Information
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NPI Number | 1518677632
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Entity Type | Organization
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Legal Business Name | SUNFLOWER HEALTHCARE LLC
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Dates
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Enumeration Date | 11/30/2022
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Last Update Date | 11/30/2022
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Provider Practice Location Address
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Address Line | 14804 N CAVE CREEK RD STE 104
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City | PHOENIX
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State | AZ
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Zip | 85032-4945
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Country | US
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Telephone | 501-613-8117
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Fax |
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Provider Business Mailing Address
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Address Line | 137 APPLE TREE CIR
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72118-1156
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Country | US
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Telephone | 501-613-8117
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MS. SHAVARIUS GASTON
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Credential |
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Telephone | 501-613-8117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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