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Contact Information

SUNBRIDGE HEALTHCARE LLC
501 W IDAHO BLVD
EMMETT, ID83617-9694
 Phone: 208-365-3597
 Fax: 208-365-5107
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for SUNBRIDGE HEALTHCARE LLC

NPI Number 1760438063
LBN Legal business name SUNBRIDGE HEALTHCARE LLC
Authorized official MICHAEL BERG - (ASSISTANT SECRETARY)
Entity Organization
Organization subpart 1 No
Enumeration date 05/26/2006
Last updated 03/27/2017 - About 9 years ago
Identifiers
ID License # 34
ID Medicaid 0029214
ID Other 01867 BLUE CROSS OF IDAHO
ID Other 000010012586 BLUE SHIELD OF IDAHO
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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