Organization
SUN LIFE FAMILY HEALTH CENTER, INC.
Active
Organization
SUN LIFE FAMILY HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVIS ROBINETTE (CHIEF EXECUTIVE OFFICER)
(520) 836-3446
Entity
Organization
Contact information
Practice address
44765 WEST HATHAWAY AVE, MARICOPA, AZ 85139-0545
(520) 568-2245
(520) 568-2316
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
OTC0187
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTC0187
LICENSE
AZ
Enumeration date
05/28/2015
Last updated
09/07/2018
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