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General NPI Number Information
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NPI Number | 1851457295
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Entity Type | Organization
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Legal Business Name | SUN LIFE FAMILY HEALTH CENTER, INC.
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 08/02/2024
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Provider Practice Location Address
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Address Line | 23 MCNAB PARKWAY
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City | SAN MANUEL
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State | AZ
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Zip | 85631
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Country | US
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Telephone | 520-385-2236
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Fax | 520-381-3237
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Provider Business Mailing Address
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Address Line | PO BOX 10097
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City | CASA GRANDE
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State | AZ
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Zip | 85130-0020
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Country | US
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Telephone | 520-836-3446
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Fax | 520-381-3237
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY/AO
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Name | MATTHEW BERTSCH
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Credential |
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Telephone | 520-836-3446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | Y03203
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License Number State | AZ
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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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