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General NPI Number Information
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NPI Number | 1316592215
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Entity Type | Organization
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Legal Business Name | SUNNY BOY PHARMACY, LLC
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Dates
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Enumeration Date | 08/07/2019
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Last Update Date | 10/02/2020
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Provider Practice Location Address
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Address Line | 4388 SUNBELT DR
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City | ADDISION
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State | TX
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Zip | 75001
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Country | US
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Telephone | 972-362-4151
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Fax | 214-594-1111
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Provider Business Mailing Address
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Address Line | 4388 SUNBELT DR
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City | ADDISION
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State | TX
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Zip | 75001
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Country | US
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Telephone | 972-362-4151
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Fax | 214-594-1111
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Authorized Official
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Title or Position | PIC
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Name | MR. NAFE SAMUEL
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Credential | PHARMD
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Telephone | 469-810-1085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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