NPIMap

Organization Active NPI

Sun Life Family Health Center, Inc

Doing business as Sun Life Family Health Center

  • Clinic Pharmacy
  • Eloy, AZ
National Provider Identifier
1609186386
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
Y005307 Issued in AZ
Legal business name
SUN LIFE FAMILY HEALTH CENTER, INC
Doing business as
Sun Life Family Health Center
Practice address
205 N Stuart Blvd
Eloy, AZ 85131-2507
Phone
(520) 999-9188
Fax
(520) 381-3237
NPI assigned
Oct 15, 2010
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X Y005307 AZ Primary

Addresses

Primary practice location

205 N Stuart Blvd
Eloy, AZ 85131-2507

Mailing address

PO Box 10097
Casa Grande, AZ 85130-0020
Phone (520) 466-7883

Other identifiers 1

IdentifierTypeStateIssuer
Y005307OtherAZPHARMACY LICENSE

Other names 1

  • Sun Life Family Health Center 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

NPI Registry JSON

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1609186386",
    "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": "520-466-7883",
            "fax_number": "520-466-3946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N STUART BLVD",
            "city": "ELOY",
            "state": "AZ",
            "postal_code": "851312507",
            "telephone_number": "520-999-9188",
            "fax_number": "520-381-3237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN LIFE FAMILY HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-15",
        "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": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "AZ",
            "license": "Y005307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "Y005307",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sun Life Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eloy, 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.