Provider Demographics
NPI:1316592215
Name:SUNNY BOY PHARMACY, LLC
Entity Type:Organization
Organization Name:SUNNY BOY PHARMACY, LLC
Other - Org Name:SUNNY BOY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:MR
Authorized Official - First Name:NAFE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMUEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:469-810-1085
Mailing Address - Street 1:4388 SUNBELT DR
Mailing Address - Street 2:
Mailing Address - City:ADDISION
Mailing Address - State:TX
Mailing Address - Zip Code:75001
Mailing Address - Country:US
Mailing Address - Phone:972-362-4151
Mailing Address - Fax:214-594-1111
Practice Address - Street 1:4388 SUNBELT DR
Practice Address - Street 2:
Practice Address - City:ADDISION
Practice Address - State:TX
Practice Address - Zip Code:75001
Practice Address - Country:US
Practice Address - Phone:972-362-4151
Practice Address - Fax:214-594-1111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-07
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy