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General NPI Number Information
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NPI Number | 1528463304
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Entity Type | Organization
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Legal Business Name | SUNSHINE COMMUNITY HEALTH CENTER, INC
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Dates
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Enumeration Date | 10/23/2014
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 24091 W LONG LAKE RD
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City | WILLOW
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State | AK
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Zip | 99688-0519
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Country | US
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Telephone | 907-733-2273
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Fax | 907-733-1735
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Provider Business Mailing Address
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Address Line | 24091 W LONG LAKE ROAD
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City | WILLOW
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State | AK
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Zip | 99688-9999
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTAILING SPECIALIST
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Name | AMANDA SIMPSON
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Credential |
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Telephone | 907-733-2273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 77895
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License Number State | AK
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