Provider Demographics
NPI:1811236219
Name:SUNSHINE PHARMACY SERVICES LTD CO
Entity Type:Organization
Organization Name:SUNSHINE PHARMACY SERVICES LTD CO
Other - Org Name:SUNSHINE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-274-0676
Mailing Address - Street 1:1231 LAKELAND HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-4673
Mailing Address - Country:US
Mailing Address - Phone:863-937-9038
Mailing Address - Fax:863-688-5462
Practice Address - Street 1:1231 LAKELAND HILLS BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-4673
Practice Address - Country:US
Practice Address - Phone:863-937-9038
Practice Address - Fax:863-688-5462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-05
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH263583336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2138667OtherPK