Provider Demographics
NPI:1528678000
Name:SUN LIFE FAMILY HEALTH CENTER INC
Entity type:Organization
Organization Name:SUN LIFE FAMILY HEALTH CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY/AO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:BERTSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-836-3446
Mailing Address - Street 1:1040 W AMERICAN AVE
Mailing Address - Street 2:
Mailing Address - City:ORACLE
Mailing Address - State:AZ
Mailing Address - Zip Code:85623-6089
Mailing Address - Country:US
Mailing Address - Phone:520-858-0006
Mailing Address - Fax:
Practice Address - Street 1:1040 W AMERICAN AVE
Practice Address - Street 2:
Practice Address - City:ORACLE
Practice Address - State:AZ
Practice Address - Zip Code:85623-6089
Practice Address - Country:US
Practice Address - Phone:520-858-0006
Practice Address - Fax:520-381-3237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-09
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy