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General NPI Number Information
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NPI Number | 1205347234
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Entity Type | Organization
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Legal Business Name | SUNRISE PHARMACY LLC
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Dates
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Enumeration Date | 10/17/2017
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Last Update Date | 10/17/2017
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Provider Practice Location Address
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Address Line | 2560 E SUNSET RD STE 102
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City | LAS VEGAS
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State | NV
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Zip | 89120-3517
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Country | US
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Telephone | 855-200-2100
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Fax | 855-631-4115
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Provider Business Mailing Address
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Address Line | 2560 E SUNSET RD STE 102
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City | LAS VEGAS
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State | NV
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Zip | 89120-3517
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL PETERS
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Credential | ESQ
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Telephone | 702-203-7301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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