Provider Demographics
NPI:1699176354
Name:SUN LIFE FAMILY HEALTH CENTER, INC
Entity Type:Organization
Organization Name:SUN LIFE FAMILY HEALTH CENTER, INC
Other - Org Name:SUN LIFE HEALTH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHARMACY/AO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-381-0363
Mailing Address - Street 1:865 N ARIZOLA RD
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-6011
Mailing Address - Country:US
Mailing Address - Phone:520-836-3446
Mailing Address - Fax:520-381-3237
Practice Address - Street 1:10032 E SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-2759
Practice Address - Country:US
Practice Address - Phone:480-339-2853
Practice Address - Fax:520-381-3237
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUN LIFE FAMILY HEALTH CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-09-11
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZY0060223336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy