Organization
SUNNYSIDE PEDIATRIC PHARMACY
Active
Other names
Sunnyside Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEHU TOMAS GRACIA PHARMD (CHIEF OPERATING OFFICER)
(361) 806-9100
Entity
Organization
Contact information
Practice address
5817 PATTON ST STE 100, CORPUS CHRISTI, TX 78414-2428
(361) 806-9100
(361) 806-9449
Mailing address
5817 PATTON ST STE 100, CORPUS CHRISTI, TX 78414-2428
(361) 806-9100
(361) 806-9449
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33859
PHARMACY LICENSE
TX
Enumeration date
07/16/2021
Last updated
07/19/2022
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