NPIMap

Organization Active NPI

Sun Life Family Health Center Inc

Doing business as Sun Life Family Health Center-Maricopa

  • Community/Retail Pharmacy
  • Maricopa, AZ
National Provider Identifier
1063887149
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
Y006493 Issued in AZ
Legal business name
SUN LIFE FAMILY HEALTH CENTER INC
Doing business as
Sun Life Family Health Center-Maricopa
Practice address
44572 W Bowlin Rd
Maricopa, AZ 85138-4558
Phone
(520) 350-7646
Fax
(520) 381-3237
NPI assigned
Dec 1, 2015
Last updated
Aug 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Matthew Bertsch
Title
Director of Pharmacy/Ao
Phone
(520) 836-3446

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Y006493 AZ Primary

Addresses

Primary practice location

44572 W Bowlin Rd
Maricopa, AZ 85138-4558

Mailing address

PO Box 10097
Casa Grande, AZ 85130-0020
Phone (520) 836-3446

Other identifiers 2

IdentifierTypeStateIssuer
088592MedicaidAZ
2154949OtherPK

Other names 1

  • Sun Life Family Health Center-Maricopa Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220211001481 AZ Part B Supplier - Pharmacy 9335032275 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Florence, AZ; San Manuel, AZ; Maricopa, AZ; Eloy, AZ; Casa Grande, AZ; Apache Junction, AZ

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Sun Life Family Health CNT15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCGHAD

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1063887149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10097",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851300020",
            "telephone_number": "520-836-3446",
            "fax_number": "520-381-3237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44572 W BOWLIN RD",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851384558",
            "telephone_number": "520-350-7646",
            "fax_number": "520-381-3237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN LIFE FAMILY HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-01",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A",
        "authorized_official_last_name": "BERTSCH",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY/AO",
        "authorized_official_telephone_number": "520-836-3446"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AZ",
            "license": "Y006493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "088592",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2154949",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sun Life Family Health Center-Maricopa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maricopa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.