Provider Demographics
NPI:1083775159
Name:SUNRISE CARE INC
Entity Type:Organization
Organization Name:SUNRISE CARE INC
Other - Org Name:PROFESSIONAL PHARMACY PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:AMIT
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJPARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-809-0984
Mailing Address - Street 1:2771 SHERMAN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-6016
Mailing Address - Country:US
Mailing Address - Phone:972-809-0984
Mailing Address - Fax:972-809-0986
Practice Address - Street 1:2771 SHERMAN ST
Practice Address - Street 2:SUITE B
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-6016
Practice Address - Country:US
Practice Address - Phone:972-809-0984
Practice Address - Fax:972-809-0986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30304333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX147114Medicaid
2157750OtherPK