NPIMap

Organization Active NPI

Sun Life Family Health Center, Inc

Doing business as Sun Life Health Pharmacy

  • Community/Retail Pharmacy
  • Mesa, AZ
National Provider Identifier
1699176354
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SUN LIFE FAMILY HEALTH CENTER, INC
Doing business as
Sun Life Health Pharmacy
Practice address
10032 E Southern Ave
Mesa, AZ 85209-2759
Phone
(480) 339-2853
Fax
(520) 381-3237
NPI assigned
Sep 11, 2014
Last updated
Aug 2, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
SUN LIFE FAMILY HEALTH CENTER, INC.As reported in NPPES

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
Clinic Pharmacy 3336C0002X Y006022 AZ
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

10032 E Southern Ave
Mesa, AZ 85209-2759

Mailing address

865 N Arizola Rd
Casa Grande, AZ 85122-6011
Phone (520) 836-3446

Other names 1

  • Sun Life Health Pharmacy 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
W Pinal Family Health C15 organizations share this tax ID, including this one
Part of
W Pinal Family Health C

Other organizations with this tax ID 14

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

View all 14

Locations

10032 E Southern Ave
Mesa, AZ 85209
Phone (480) 339-2853

NPI Registry JSON

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1699176354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 N ARIZOLA RD",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851226011",
            "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": "10032 E SOUTHERN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852092759",
            "telephone_number": "480-339-2853",
            "fax_number": "520-381-3237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN LIFE FAMILY HEALTH CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUN LIFE FAMILY HEALTH CENTER, INC.",
        "enumeration_date": "2014-09-11",
        "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": "Y006022",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sun Life Health Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, 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.