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General NPI Number Information
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NPI Number | 1881189157
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Entity Type | Organization
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Legal Business Name | SUNSET APOTHECARY, LLC
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Dates
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Enumeration Date | 06/28/2018
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Last Update Date | 06/28/2018
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Provider Practice Location Address
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Address Line | 1506 S SUNSET AVENUE, STE A2
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City | LITTLEFIELD
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State | TX
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Zip | 79339-4899
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Country | US
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Telephone | 806-385-4491
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Fax |
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Provider Business Mailing Address
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Address Line | 1506 S SUNSET AVE STE A
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City | LITTLEFIELD
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State | TX
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Zip | 79339-4813
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Country | US
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Telephone | 806-385-4491
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MICAH G PRATT
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Credential | PHARMACIST
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Telephone | 806-385-4491
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 32135
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License Number State | TX
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