Organization
LAMP FOOD STORES INC
Active
Other names
SUN FRESH PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ROSARIO PASSANTINO RPH (PRESIDENT/CO-OWNER)
(816) 252-0138
Entity
Organization
Contact information
Practice address
2301 S STERLING AVE, INDEPENDENCE, MO 64052-3666
(816) 461-1287
(816) 252-5860
Mailing address
2301 S STERLING AVE, INDEPENDENCE, MO 64052-3666
(816) 461-1287
(816) 252-5860
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
005649
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2047142
PK
—
05
—
602303604
—
MO
Enumeration date
11/17/2006
Last updated
11/13/2014
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