Provider Demographics
NPI:1487697520
Name:SUN HEALTH CORPORATION
Entity type:Organization
Organization Name:SUN HEALTH CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:V.P C.F.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:T
Authorized Official - Last Name:SELLNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-544-5068
Mailing Address - Street 1:PO BOX 1278
Mailing Address - Street 2:ATTN: MINDY OGDEN, CPCS, CPMSM
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85372-1278
Mailing Address - Country:US
Mailing Address - Phone:623-544-5075
Mailing Address - Fax:623-544-5093
Practice Address - Street 1:15468 N. CIVIC CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374
Practice Address - Country:US
Practice Address - Phone:623-584-2917
Practice Address - Fax:623-584-2945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0425950OtherBLUE CROSS BLUE SHIELD AZ