Provider Demographics
NPI:1154767663
Name:SUNSHINE PHARMACY
Entity type:Organization
Organization Name:SUNSHINE PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NEW OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALDOFO
Authorized Official - Middle Name:
Authorized Official - Last Name:REQUENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-352-2033
Mailing Address - Street 1:5480 RATTLESNAKE HAMMOCK RD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34113-7454
Mailing Address - Country:US
Mailing Address - Phone:239-775-6800
Mailing Address - Fax:239-775-7377
Practice Address - Street 1:5480 RATTLESNAKE HAMMOCK RD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34113-7454
Practice Address - Country:US
Practice Address - Phone:239-775-0600
Practice Address - Fax:239-775-3750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-13
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy