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Organization

SUN LIFE FAMILY HEALTH CENTER, INC.

Active
Other names
Sun Life Family Health Center
Organization subpart
No

Provider details

NPI number
Authorized official
TRAVIS ROBINETTE (CHIEF EXECUTIVE OFFICER)
(520) 836-3446
Entity
Organization

Contact information

Practice address
205 N STUART BLVD, ELOY, AZ 85131-2507
(520) 466-7883
(520) 466-3946
Mailing address
PO BOX 10097, CASA GRANDE, AZ 85130-0020
(520) 836-3446
(520) 836-8807

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
258
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
AZ04288
AZ
01
ZFQ31813
MEDICARE PTAN
Enumeration date
05/04/2007
Last updated
08/03/2017
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