1508934720 NPI number — SUN HEALTH CORPORATION

Table of content: (NPI 1508934720)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508934720 NPI number — SUN HEALTH CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUN HEALTH CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SUN HEALTH BEHAVIORAL MEDICINE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508934720
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1278
Provider Second Line Business Mailing Address:
ATTN MINDY OGDEN
Provider Business Mailing Address City Name:
SUN CITY
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85372-1278
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
623-544-5075
Provider Business Mailing Address Fax Number:
623-544-5093

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10401 W THUNDERBIRD BLVD
Provider Second Line Business Practice Location Address:
ATTN BEHAVIORAL MEDICINE
Provider Business Practice Location Address City Name:
SUN CITY
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85351-3004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
623-876-5459
Provider Business Practice Location Address Fax Number:
623-876-5693
Provider Enumeration Date:
12/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SELLNER
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
T.
Authorized Official Title or Position:
VP, CFO
Authorized Official Telephone Number:
623-876-6616

Provider Taxonomy Codes

  • Taxonomy code: 103G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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