Provider Demographics
NPI:1295215507
Name:RISE N SHINE PHARMACY INC
Entity Type:Organization
Organization Name:RISE N SHINE PHARMACY INC
Other - Org Name:PHARMACIA EL AMANECER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:NOVELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-447-7784
Mailing Address - Street 1:17913 NW 7TH ST STE 104
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-2811
Mailing Address - Country:US
Mailing Address - Phone:954-447-7751
Mailing Address - Fax:954-447-7785
Practice Address - Street 1:17913 NW 7 STREET
Practice Address - Street 2:SUITE 104
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029
Practice Address - Country:US
Practice Address - Phone:954-447-7784
Practice Address - Fax:954-447-7785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-16
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000719400Medicaid