Provider Demographics
NPI:1083668578
Name:SUN HEALTH CORPORATION
Entity Type:Organization
Organization Name:SUN HEALTH CORPORATION
Other - Org Name:WALTER O BOSWELL REHAB UNIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-876-5357
Mailing Address - Street 1:10601 W SANTA FE DR
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-3036
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10601 W SANTA FE DR
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3036
Practice Address - Country:US
Practice Address - Phone:623-974-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUN HEALTH BOSWELL HOSP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-20
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZH0131273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ020793Medicaid
AZF01176OtherPHOENIX HEALTH PLAN
AZ770000002000OtherTMG
AZIZ0046OtherHEALTH NET
AZAZ0201950OtherBCBSAZ
AZ020793Medicaid
AZ03T061Medicare PIN