Organization
SUNNY ENTERPRISE INC
Active
Other names
westport medical
Organization subpart
No
Provider details
NPI number
Authorized official
CURTIS WIGGINS (OWNER)
(502) 425-4726
Entity
Organization
Contact information
Practice address
8700 WESTPORT RD # SU112, LOUISVILLE, KY 40242-3100
(502) 425-4726
(502) 425-7560
Mailing address
8700 WESTPORT RD, SUITE #112, LOU, KY 40242
(502) 425-4726
(502) 425-7560
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33000365
—
KY
Enumeration date
01/30/2007
Last updated
08/19/2008
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