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NPI Code Detail

MEDICARE: SUNSHINE CONCEPTS LLC

MEDICARE: SUNSHINE CONCEPTS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturistAC00490OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11245407980OTHERORNPPES

General Provider Information

NPI Number : 1124531512
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUNSHINE CONCEPTS LLC
Provider Business Mailing Address
First Line : PO BOX 923
Second Line :
City : SUTHERLIN
State : OR
Zip : 97479-0923
Country : US
Telephone Number : 541-430-7410
Fax Number :
Provider Business Practice Location Address
First Line : 100 EAST CENTRAL AVE.
Second Line : 10 SOUTH STATE ST. BACK OF BLDG
City : SUTHERLIN
State : OR
Zip : 97479-9556
Country : US
Telephone Number : 541-459-7410
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : LORI CELESTE FARLEY
Credential : L.AC.
Telephone Number : 541-430-5393
Provider Enumeration Date : 11/08/2017
Last Update Date : 11/08/2017

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Directions to “SUNSHINE CONCEPTS LLC ” Practice Location

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