MEDICARE: SUNSHINE PHARMACY MEDICAL INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	PH22051	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1019567	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1215978275
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSHINE PHARMACY MEDICAL INC

Provider Business Mailing Address
First Line	:	6350 DAVIS BLVD
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34104-5323
Country	:	US
Telephone Number	:	239-775-7207
Fax Number	:	239-963-3098

Provider Business Practice Location Address
First Line	:	6350 DAVIS BLVD
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34104-5323
Country	:	US
Telephone Number	:	239-775-7207
Fax Number	:	239-963-3098

Authorized Official
Title or Position	:	OWNER
Name	:	DEL PARRISH
Credential	:
Telephone Number	:	239-775-6800

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	01/07/2011

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