Healthcare Provider Details

I. General information

NPI: 1285983007
Provider Name (Legal Business Name): SUN CITY PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2012
Last Update Date: 11/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9133 W THUNDERBIRD RD STE 101
PEORIA AZ
85381-4269
US

IV. Provider business mailing address

9133 W THUNDERBIRD RD STE 101
PEORIA AZ
85381-4269
US

V. Phone/Fax

Practice location:
  • Phone: 623-322-6664
  • Fax: 623-322-6668
Mailing address:
  • Phone: 623-322-6664
  • Fax: 623-322-6668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberY005538
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MOHAMED HASSANEIN-ELEMBABI
Title or Position: PHARMACIST/OWNER
Credential:
Phone: 623-760-5572