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General NPI Number Information
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NPI Number | 1528498227
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Entity Type | Organization
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Legal Business Name | SUNSHINE PHARMACY, INC.
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Dates
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Enumeration Date | 11/15/2013
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Last Update Date | 11/15/2013
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Provider Practice Location Address
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Address Line | 206 E STATE ST SUITE 1
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City | BLACK MOUNTAIN
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State | NC
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Zip | 28711-3541
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Country | US
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Telephone | 828-669-0090
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Fax | 828-669-0094
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Provider Business Mailing Address
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Address Line | 206 E STATE ST SUITE 1
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City | BLACK MOUNTAIN
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State | NC
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Zip | 28711-3541
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Country | US
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Telephone | 828-669-0090
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Fax | 828-669-0094
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. AMANDA BROWN NICHOLS
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Credential | R. PH.
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Telephone | 828-669-0090
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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 | 10030
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License Number State | NC
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