Provider Demographics
NPI:1588832497
Name:SUNSHINE PHARMACY INC
Entity Type:Organization
Organization Name:SUNSHINE PHARMACY INC
Other - Org Name:SUNSHINE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:B
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:828-275-6469
Mailing Address - Street 1:206 E STATE ST STE 1
Mailing Address - Street 2:
Mailing Address - City:BLACK MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28711-3545
Mailing Address - Country:US
Mailing Address - Phone:828-669-0090
Mailing Address - Fax:
Practice Address - Street 1:206 E STATE ST STE 1
Practice Address - Street 2:
Practice Address - City:BLACK MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28711-3545
Practice Address - Country:US
Practice Address - Phone:828-669-0090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19157183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty