SUN LIFE FAMILY HEALTH CENTER, INC (NPI# 1417286568) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417286568 |
| Entity Type | Organization |
| Organization Name | SUN LIFE FAMILY HEALTH CENTER, INC |
| Other Organization Name | SUN LIFE CENTER FOR CHILDREN |
| Practice Address |
1856 E Florence Blvd Casa Grande AZ 85122-5303 |
| Mailing Address |
Po Box 10097 Casa Grande AZ 85130-0020 |
| Practice Telephone | 5203810380 |
| Practice Fax Number | 5208361826 |
| Mailing Telephone | 5208363446 |
| Mailing Fax Number | 5208368807 |
| Enumeration Date | 2009-12-21 |
| Last Update Date | 2017-08-03 |
| Authorized Official Name | TRAVIS ROBINETTE (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 5208363446 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
OTC4752 | AZ | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | MEDICARE | ZFQ31815 | 01 |
| AZ | MEDICARE | 03-1881 | 01 |
| AZ | CITY BUSINESS LICENSE | BL-09-55271 | 01 |
| AZ | AZ13154 | 05 |
| Other Name | Type Code |
|---|---|
| Sun Life Center for Children | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396275459 | Sun Life Family Health Center, Inc | Clinic/Center | 655 S Dobson Rd Ste 201, Chandler, AZ 85224-5669 | 2017-06-12 |
| 1609186386 | Sun Life Family Health Center, Inc | Pharmacy | 205 N Stuart Blvd, Eloy, AZ 85131-2507 | 2010-10-15 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SUN LIFE FAMILY HEALTH CENTER, INC | 865 N Arizola Rd, Casa Grande, AZ 85230-6011 |
| Street Address |
1856 E FLORENCE BLVD |
| City | CASA GRANDE |
| State | AZ |
| Zip Code | 85122-5303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295713741 | Maria Abad | Pediatrics | 1856 E Florence Blvd, Casa Grande, AZ 85122 | 2006-01-05 |
| 1851528558 | Christine Rose James | Pediatrics | 1856 E Florence Blvd, Casa Grande, AZ 85122 | 2009-06-19 |
| 1114941135 | Maria Mercedes Alba | Pediatrics | 1856 E Florence Blvd, Casa Grande, AZ 85122-5303 | 2006-07-26 |
| 1730107558 | Aaron Gloskowski | Family Medicine | 1856 E Florence Blvd, Casa Grande, AZ 85222-5303 | 2006-07-18 |
| 1295780351 | Brian L Seyler | Family Medicine | 1856 E Florence Blvd, Casa Grande, AZ 85222-5303 | 2006-05-24 |
| 1124088968 | Rudolph Bustamante | Pediatrics | 1856 E Florence Blvd, Casa Grande, AZ 85122-5303 | 2006-03-24 |
| 1740249945 | Melissa Ann Byram | Pediatrics | 1856 E Florence Blvd, Casa Grande, AZ 85122-5303 | 2006-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043857097 | Karen M Garcia | Registered Nurse | 2631 N Brown Avenue, Casa Grande, AZ 85122 | 2019-12-09 |
| 1063060291 | Martha Bollin | Registered Nurse | 2631 N. Brown Ave., Casa Grande, AZ 85122 | 2019-08-30 |
| 1841846920 | Banner Imaging Services LLC | Radiology | 1828 E. Florence Blvd Bldg B Ste 118 & 128, Suite 118 and 128, Casa Grande, AZ 85122 | 2019-08-14 |
| 1629532692 | Kirk Lee Mackley | Physical Therapist | Vibrant Care, 1355 E Florence Blvd #137, Casa Grande, AZ 85122 | 2019-01-24 |
| 1205307436 | Natalie T Trujillo | Physician Assistant | 301 E Cottonwood Ln Ste 1&2, Casa Grande, AZ 85122 | 2018-12-16 |
| 1710455860 | Community Intervention Associates, Inc | Clinic/Center | 1667 N. Trekell Rd, Suite 101 & 102, Casa Grande, AZ 85122 | 2018-11-07 |
| 1245728302 | Jenkins Chiropractic LLC | Chiropractor | 1891 N Trekell Rd Ste 2, Casa Grande, AZ 85122 | 2018-04-24 |
| 1497242408 | Kelly Winnett | Naturopath | 1415 N Trekell Rd Ste 102, Casa Grande, AZ 85122 | 2018-04-16 |
| 1851895783 | Michael Brubaker Counseling | Community/Behavioral Health | 1927 N. Trekell Rd, Ste D, Casa Grande, AZ 85122 | 2018-03-23 |
| 1770095317 | Walmart Stores Inc. | Pharmacy | 1741 E. Florence Blvd, Casa Grande, AZ 85122 | 2017-11-03 |
| Find all providers in zip 85122 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073091328 | Horizon Health and Wellness, Inc. | Clinic/Center | 115 W 2nd St, Casa Grande, AZ 85122-4406 | 2018-07-30 |
| 1548690332 | Sun Life Family Health Center, Inc. | Clinic/Center | 1864 E Florence Blvd, Casa Grande, AZ 85122-5457 | 2013-11-15 |
| 1891913166 | Sun Life Family Health Center, Inc. | Clinic/Center | 865 N Arizola Rd, Casa Grande, AZ 85122-6011 | 2007-04-23 |
| 1689778623 | Sun Life Family Health Center, Inc. | Clinic/Center | 865 N Arizola Rd, Casa Grande, AZ 85122-6011 | 2006-09-11 |
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| 1821582529 | Chiricahua Community Health Centers, Inc | Clinic/Center | 335 South Ocotillo Avenue, Benson, AZ 85602 | 2018-06-18 |
| 1881198992 | Valle Del Sol, Inc. | Clinic/Center | 334 W 10th Pl Ste 100, Mesa, AZ 85201-3499 | 2018-03-22 |
| 1841706785 | Circle The City | Clinic/Center | 206 S 12th Ave, Phoenix, AZ 85007 | 2017-12-14 |
| 1346755295 | Circle The City | Clinic/Center | 210 S 12th Ave, Phoenix, AZ 85007-3101 | 2017-12-13 |
| Find all providers with the same taxonomy | ||||
| City | CASA GRANDE |
| Zip Code | 85122 |
Please comment or provide details below to improve the information on SUN LIFE FAMILY HEALTH CENTER, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.