Provider Demographics
NPI:1982475190
Name:SCOTTSDALE SUNSHINE LLC DBA
Entity Type:Organization
Organization Name:SCOTTSDALE SUNSHINE LLC DBA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MALONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-330-1191
Mailing Address - Street 1:7904 E CHAPARRAL RD STE A110-207
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-7295
Mailing Address - Country:US
Mailing Address - Phone:480-330-1191
Mailing Address - Fax:
Practice Address - Street 1:8111 E THOMAS RD STE 112
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5876
Practice Address - Country:US
Practice Address - Phone:480-330-1191
Practice Address - Fax:480-269-9939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care