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General NPI Number Information
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NPI Number | 1255770459
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Entity Type | Organization
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Legal Business Name | SUN PHARMACY SERVICES LLC
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Dates
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Enumeration Date | 06/20/2013
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Last Update Date | 06/20/2013
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Provider Practice Location Address
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Address Line | 3549 1ST ST
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City | BRADENTON
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State | FL
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Zip | 34208-4441
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Country | US
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Telephone | 941-448-4751
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Fax |
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Provider Business Mailing Address
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Address Line | 3549 1ST ST
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City | BRADENTON
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State | FL
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Zip | 34208-4441
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Country | US
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Telephone | 941-448-4751
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Fax |
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | MR. MAGED FARAG
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Credential |
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Telephone | 941-448-4751
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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 | PH26911
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | PH26911
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH26911
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License Number State | FL
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