Provider Demographics
NPI:1922480227
Name:NORTHERN SUN FAMILY HEALTH CARE
Entity Type:Organization
Organization Name:NORTHERN SUN FAMILY HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:TALBOTT
Authorized Official - Last Name:ACKERLY
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:207-798-3993
Mailing Address - Street 1:53 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TOPSHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04086-1234
Mailing Address - Country:US
Mailing Address - Phone:207-798-3993
Mailing Address - Fax:
Practice Address - Street 1:53 MAIN ST
Practice Address - Street 2:
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-1234
Practice Address - Country:US
Practice Address - Phone:207-798-3993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-23
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center