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General NPI Number Information
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NPI Number | 1740005792
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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 | 11/15/2024
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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 | 907-733-1753
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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 | 907-733-1753
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Authorized Official
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Title or Position | CREDENTIALING 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 | 333600000X
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Taxonomy Name | Pharmacy
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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