Healthcare Provider Details
I. General information
NPI: 1689989022
Provider Name (Legal Business Name): SUNSHINE PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/10/2010
Last Update Date: 12/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
43009 HAYES RD
STERLING HEIGHTS MI
48313-2352
US
IV. Provider business mailing address
43009 HAYES RD
STERLING HEIGHTS MI
48313-2352
US
V. Phone/Fax
- Phone: 586-286-5005
- Fax: 586-286-5151
- Phone: 586-286-5005
- Fax: 586-286-5151
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 5301009393 |
| License Number State | MI |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANDREA
ROWINSKI
Title or Position: OWNER / MANAGING PHARMACIST
Credential:
Phone: 586-286-5005