Provider Demographics
NPI:1508603937
Name:AMERICAN SUNRISE CARE-ASC-LLC
Entity type:Organization
Organization Name:AMERICAN SUNRISE CARE-ASC-LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNENY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-312-3230
Mailing Address - Street 1:9276 OLD KEENE MILL ROAD
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015
Mailing Address - Country:US
Mailing Address - Phone:571-516-3116
Mailing Address - Fax:571-516-3070
Practice Address - Street 1:9276 OLD KEENE MILL ROAD
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015
Practice Address - Country:US
Practice Address - Phone:571-516-3116
Practice Address - Fax:571-516-3070
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN SUNRISE CARE-ASC-LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty