MEDICARE: SUN LIFE FAMILY HEALTH CENTER, INC.

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
1	261QF0400X	Federally Qualified Health Center (FQHC)	OTC6229	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548690332
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUN LIFE FAMILY HEALTH CENTER, INC.

Provider Business Mailing Address
First Line	:	PO BOX 10097
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85130-0020
Country	:	US
Telephone Number	:	520-836-3446
Fax Number	:

Provider Business Practice Location Address
First Line	:	580 N CAMINO MERCADO STE 8
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85122-5757
Country	:	US
Telephone Number	:	520-381-0380
Fax Number	:	520-836-1826

Authorized Official
Title or Position	:	DIRECTOR OF FINANCE
Name	:	KATE TURVIN
Credential	:
Telephone Number	:	520-381-0383

Provider Enumeration Date	:	11/15/2013
Last Update Date	:	12/02/2021

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