Provider Demographics
NPI:1316205271
Name:SUNSHINE RX LLC
Entity Type:Organization
Organization Name:SUNSHINE RX LLC
Other - Org Name:ECKERDS PHARMACY 103
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VIKRAM
Authorized Official - Middle Name:BACHUBHAI
Authorized Official - Last Name:RAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-774-3536
Mailing Address - Street 1:5139 MANATEE AVE W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-3740
Mailing Address - Country:US
Mailing Address - Phone:941-538-7122
Mailing Address - Fax:941-538-7133
Practice Address - Street 1:5139 MANATEE AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-3740
Practice Address - Country:US
Practice Address - Phone:941-538-7122
Practice Address - Fax:941-538-7133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-30
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336L0003X, 333600000X, 3336C0004X
FLPH261013336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL005551601Medicaid
FL005551600Medicaid
2134911OtherPK
6789930001Medicare NSC