Healthcare Provider Details

I. General information

NPI: 1699959817
Provider Name (Legal Business Name): SUNSHINE PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2007
Last Update Date: 12/01/2020
Certification Date: 12/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 W COLORADO AVE
TELLURIDE CO
81435-0104
US

IV. Provider business mailing address

PO BOX 104
TELLURIDE CO
81435-0702
US

V. Phone/Fax

Practice location:
  • Phone: 970-728-3601
  • Fax: 970-728-1366
Mailing address:
  • Phone: 970-728-3601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number1180000001
License Number StateCO

VIII. Authorized Official

Name: KARYN HEMPHILL
Title or Position: OWNER AND PHARMACIST
Credential: RPH
Phone: 970-728-3601