Organization
SUN HEALTH LAKES IMAGING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY BURTON (CHIEF EXECUTIVE OFFICER)
(623) 876-5356
Entity
Organization
Contact information
Practice address
10474 W THUNDERBIRD BLVD, SUITE 100, SUN CITY, AZ 85351-3015
(623) 876-5351
Mailing address
PO BOX 5430, SUN CITY WEST, AZ 85376-5430
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
OTC-3641
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2Z1539
HEALTH NET
AZ
01
—
5500000S0215
TMG
AZ
05
—
898190
—
AZ
01
—
AZ0761130
BCBSAZ
AZ
01
—
P00160563
LAKES MEDICARE RR (216)
AZ
Enumeration date
05/18/2006
Last updated
08/22/2020
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