Provider Demographics
NPI:1033215793
Name:SUNSHINE HEALTH CARE, INC
Entity Type:Organization
Organization Name:SUNSHINE HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:662-489-1189
Mailing Address - Street 1:1677 HIGHWAY 9 N
Mailing Address - Street 2:
Mailing Address - City:PONTOTOC
Mailing Address - State:MS
Mailing Address - Zip Code:38863-9279
Mailing Address - Country:US
Mailing Address - Phone:662-489-1189
Mailing Address - Fax:
Practice Address - Street 1:1677 HIGHWAY 9 N
Practice Address - Street 2:
Practice Address - City:PONTOTOC
Practice Address - State:MS
Practice Address - Zip Code:38863-9279
Practice Address - Country:US
Practice Address - Phone:662-489-1189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS118314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00023140Medicaid
MS00023140Medicaid