Provider Demographics
NPI:1215921796
Name:SUNSHINE DRUGS, INC.
Entity type:Organization
Organization Name:SUNSHINE DRUGS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARM D/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:NORFLEET
Authorized Official - Last Name:BRIDGES
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:352-796-7200
Mailing Address - Street 1:90 PONCE DE LEON BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34601-2816
Mailing Address - Country:US
Mailing Address - Phone:352-796-7200
Mailing Address - Fax:352-796-6890
Practice Address - Street 1:90 PONCE DE LEON BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34601-2816
Practice Address - Country:US
Practice Address - Phone:352-796-7200
Practice Address - Fax:352-796-6890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-09
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH-15698332B00000X, 333600000X
FLPH15698333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000496700Medicaid
FL1082128OtherNCPDP
FL000496700Medicaid
1229960001Medicare UPIN