Provider Demographics
NPI:1912418435
Name:SUNRISE MEDICAL ASSOCIATES INC.
Entity Type:Organization
Organization Name:SUNRISE MEDICAL ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACILITY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HAYLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GREGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-641-1033
Mailing Address - Street 1:9 WORTH CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-4358
Mailing Address - Country:US
Mailing Address - Phone:423-641-1033
Mailing Address - Fax:866-560-9772
Practice Address - Street 1:9 WORTH CIR STE 100
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-4358
Practice Address - Country:US
Practice Address - Phone:423-641-1033
Practice Address - Fax:866-560-9772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty