Provider Demographics
NPI:1477024677
Name:SUNEXPRESS PHARMACY INC.
Entity Type:Organization
Organization Name:SUNEXPRESS PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:VOSOUGHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-296-1333
Mailing Address - Street 1:906 N US HIGHWAY 41 STE A
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33570-3544
Mailing Address - Country:US
Mailing Address - Phone:813-296-1333
Mailing Address - Fax:813-331-0439
Practice Address - Street 1:906 N US HIGHWAY 41 STE A
Practice Address - Street 2:
Practice Address - City:RUSKIN
Practice Address - State:FL
Practice Address - Zip Code:33570-3544
Practice Address - Country:US
Practice Address - Phone:813-296-1333
Practice Address - Fax:813-331-0439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy