Provider Demographics
NPI:1699313767
Name:SUNFLOWER RX, LLC
Entity type:Organization
Organization Name:SUNFLOWER RX, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:432-606-2394
Mailing Address - Street 1:110 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-4506
Mailing Address - Country:US
Mailing Address - Phone:432-606-2394
Mailing Address - Fax:432-363-4803
Practice Address - Street 1:110 E 7TH ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4506
Practice Address - Country:US
Practice Address - Phone:432-606-2394
Practice Address - Fax:432-363-4803
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNFLOWER RX, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-19
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy