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General NPI Number Information
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NPI Number | 1568902583
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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 | 02/24/2017
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Last Update Date | 02/24/2017
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Provider Practice Location Address
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Address Line | 42728 S PARKS HIGHWAY
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City | TALKEETNA
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State | AK
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Zip | 99676
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Country | US
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Telephone | 907-733-2273
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Fax |
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Provider Business Mailing Address
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Address Line | HC 89 BOX 8190
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City | TALKEETNA
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State | AK
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Zip | 99676-9701
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Country | US
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Telephone | 907-733-2273
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MELODY WEST
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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 | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number | 77895
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License Number State | AK
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