Provider Demographics
NPI:1275127102
Name:SUNSHINE PHARMACY OF CASSELBERRY LLC
Entity Type:Organization
Organization Name:SUNSHINE PHARMACY OF CASSELBERRY LLC
Other - Org Name:SUNSHINE PHARMACY OF CASSELBERRY
Other - Org Type:Other Name
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:ANGELETE
Authorized Official - Last Name:SLATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-790-7289
Mailing Address - Street 1:5040 W STATE ROAD 46 STE 1126
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-9252
Mailing Address - Country:US
Mailing Address - Phone:407-878-4272
Mailing Address - Fax:
Practice Address - Street 1:2915 LAKEVIEW DR STE 1061
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32730-2009
Practice Address - Country:US
Practice Address - Phone:407-790-7289
Practice Address - Fax:321-295-7978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-22
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy