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 (CHEIF EXECUTIVE OFFICER)
(520) 836-3446
Entity
Organization
Contact information
Practice address
865 N ARIZOLA RD, CASA GRANDE, AZ 85122-6011
(520) 836-3446
(520) 836-8807
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZFQ31813
MEDICARE PTAN
—
01
—
ZFQ31814
MEDICARE PTAN
—
01
—
ZFQ31815
MEDICARE PTAN
—
01
—
ZFQ31820
MEDICARE PTAN
—
01
—
ZFQ61788
MEDICARE PTAN
—
Enumeration date
09/11/2006
Last updated
08/03/2017
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