Provider Demographics
NPI:1790899029
Name:SUNRISE PHARMACY, INC
Entity Type:Organization
Organization Name:SUNRISE PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOSES
Authorized Official - Middle Name:O
Authorized Official - Last Name:NWAIGWE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:361-887-9226
Mailing Address - Street 1:2601 HOSPITAL BLVD
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78405-1815
Mailing Address - Country:US
Mailing Address - Phone:361-887-9226
Mailing Address - Fax:
Practice Address - Street 1:2601 HOSPITAL BLVD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405-1815
Practice Address - Country:US
Practice Address - Phone:361-887-9226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22317183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty