Healthcare Provider Details

I. General information

NPI: 1730564733
Provider Name (Legal Business Name): SUNSHINE PHARMACY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2015
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1856 S LAKE DR STE K
LEXINGTON SC
29073-7225
US

IV. Provider business mailing address

634 PINE RIDGE DR STE B
WEST COLUMBIA SC
29172-1885
US

V. Phone/Fax

Practice location:
  • Phone: 803-399-7701
  • Fax: 803-399-7702
Mailing address:
  • Phone: 803-939-8489
  • Fax: 803-399-7702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number16079
License Number StateSC

VIII. Authorized Official

Name: KYLE MCHUGH
Title or Position: OWNER
Credential:
Phone: 803-399-7701