Provider Demographics
NPI:1760638720
Name:SUNSHINE INFUSION SERVICES INC
Entity Type:Organization
Organization Name:SUNSHINE INFUSION SERVICES INC
Other - Org Name:BIOLOGICTX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO & SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SLUPECKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-385-7322
Mailing Address - Street 1:3300 CORPORATE AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3504
Mailing Address - Country:US
Mailing Address - Phone:954-385-7322
Mailing Address - Fax:954-835-7324
Practice Address - Street 1:1976 RAYMOND DR
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-6715
Practice Address - Country:US
Practice Address - Phone:888-892-7607
Practice Address - Fax:224-235-4516
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIOLOGICTX LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-11
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL054.019338333600000X
3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2154369OtherPK