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Organization
SUNTREE PHARMACY
Active
Organization
SUNTREE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIAHN CLARK (OWNER)
(321) 253-3535
Entity
Organization
Contact information
Practice address
7640 N. WICKHAM RD #117, MELBOURNE, FL 32940
(321) 253-3535
(321) 253-2522
Mailing address
7640 N. WICKHAM RD #117, MELBOURNE, FL 32940
(321) 253-3535
(321) 253-2522
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PH18030
FL
183500000X
Pharmacist
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000042400
—
FL
05
—
026219600
—
FL
01
—
PH18030
PHARMACY LICENSE
FL
Enumeration date
12/08/2006
Last updated
03/07/2023
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