Healthcare Provider Details

I. General information

NPI: 1952308280
Provider Name (Legal Business Name): SUNRISE MEDICATIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 10/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 PALMETTO WOOD PKWY STE 100
IRMO SC
29063-2881
US

IV. Provider business mailing address

PO BOX 1928
LEXINGTON SC
29071-1928
US

V. Phone/Fax

Practice location:
  • Phone: 877-936-1045
  • Fax: 877-936-9735
Mailing address:
  • Phone: 803-957-0500
  • Fax: 888-342-6190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number15202
License Number StateSC

VIII. Authorized Official

Name: MRS. CHRISTINA M JEFFCOAT
Title or Position: VICE PRESIDENT
Credential:
Phone: 803-957-0500