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General NPI Number Information
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NPI Number | 1427350479
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Entity Type | Organization
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Legal Business Name | SUNRISE NATURAL PHARMACY, LLC
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Dates
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Enumeration Date | 11/24/2010
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Last Update Date | 11/24/2010
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Provider Practice Location Address
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Address Line | 925 N FEDERAL HWY
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City | FT LAUDERDALE
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State | FL
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Zip | 33304-2706
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Country | US
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Telephone | 305-374-1029
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Fax |
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Provider Business Mailing Address
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Address Line | 925 N FEDERAL HWY
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City | FT LAUDERDALE
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State | FL
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Zip | 33304-2706
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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 | MGRM
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Name | SUZETTE WOODS
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Credential |
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Telephone | 305-374-1029
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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 | PH25029
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License Number State | FL
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