Provider Demographics
NPI:1376271957
Name:TITHEOTOKOS, LLC
Entity Type:Organization
Organization Name:TITHEOTOKOS, LLC
Other - Org Name:SUNSHINE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAHA
Authorized Official - Middle Name:
Authorized Official - Last Name:TADROUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-766-9155
Mailing Address - Street 1:1995 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-0960
Mailing Address - Country:US
Mailing Address - Phone:772-999-2843
Mailing Address - Fax:772-999-2839
Practice Address - Street 1:1995 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-0960
Practice Address - Country:US
Practice Address - Phone:772-999-2843
Practice Address - Fax:772-999-2839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-11
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL115503800Medicaid