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NPI Code Detail

MEDICARE: SUNBRIDGE HEALTHCARE LLC

MEDICARE: SUNBRIDGE HEALTHCARE 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
1314000000XSkilled Nursing Facility1337WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17080WHOTHERWAREGENCE BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710933999
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUNBRIDGE HEALTHCARE LLC
Provider Business Mailing Address
First Line : 101 SUN AVE NE
Second Line : COMPLIANCE DEPARTMENT
City : ALBUQUERQUE
State : NM
Zip : 87109-4373
Country : US
Telephone Number : 505-468-5604
Fax Number : 505-468-4681
Provider Business Practice Location Address
First Line : 820 NW 95TH ST
Second Line :
City : SEATTLE
State : WA
Zip : 98117-2207
Country : US
Telephone Number : 206-782-0100
Fax Number : 206-781-1448
Authorized Official
Title or Position : ASSISTANT SECRETARY
Name : MICHAEL BERG
Credential :
Telephone Number : 505-821-3355
Provider Enumeration Date : 05/26/2006
Last Update Date : 07/13/2015

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Directions to “SUNBRIDGE HEALTHCARE LLC ” Practice Location

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