Provider Demographics
NPI:1629213418
Name:SUNSHINE PHARMACY AND SUPPLIES INC.
Entity Type:Organization
Organization Name:SUNSHINE PHARMACY AND SUPPLIES INC.
Other - Org Name:SUNSHINE MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOITIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-469-9654
Mailing Address - Street 1:8159 NW 66TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166-2733
Mailing Address - Country:US
Mailing Address - Phone:305-887-2460
Mailing Address - Fax:305-220-4374
Practice Address - Street 1:8159 NW 66TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166
Practice Address - Country:US
Practice Address - Phone:305-887-2460
Practice Address - Fax:305-220-4374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-08
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1313949332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
1043354OtherNCPDP PROVIDER IDENTIFICATION NUMBER
1043354OtherNCPDP PROVIDER IDENTIFICATION NUMBER