Provider Demographics
NPI:1700356292
Name:SUNSET COMMUNITY HEALTH CENTER
Entity Type:Organization
Organization Name:SUNSET COMMUNITY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT CREDENTIAL
Authorized Official - Prefix:
Authorized Official - First Name:LUISANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-819-8834
Mailing Address - Street 1:675 S AVENUE B BLDG B
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-2749
Mailing Address - Country:US
Mailing Address - Phone:928-819-8999
Mailing Address - Fax:928-539-5579
Practice Address - Street 1:675 S AVENUE B BLDG B
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-2749
Practice Address - Country:US
Practice Address - Phone:928-819-8999
Practice Address - Fax:928-539-5579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-28
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty