Organization
SUNRISE GOLD LLC
Active
Other names
Sunridge LTC Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MA SUSAN ABULENCIA (PHARMACIST-IN-CHARGE/PRESIDENT)
(916) 500-3303
Entity
Organization
Contact information
Practice address
11460 SUNRISE GOLD CIR STE F, RANCHO CORDOVA, CA 95742-6572
(916) 500-3303
(916) 244-7344
Mailing address
11460 SUNRISE GOLD CIR STE F, RANCHO CORDOVA, CA 95742-6572
(916) 500-3303
(916) 244-7344
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY56812
BOARD OF PHARMACY
CA
Enumeration date
03/08/2019
Last updated
05/08/2019
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