Organization
SUNRISE ENTERPRISES INC
Active
Other names
mountainview pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JANE UKOH (OWNER)
(770) 272-9612
Entity
Organization
Contact information
Practice address
1275 POWERS FERRY RD SE STE 170, MARIETTA, GA 30067-9487
(770) 272-9612
(770) 272-9613
Mailing address
1275 POWERS FERRY RD SE, SUITE 170, MARIETTA, GA 30067-9486
(770) 272-9612
(770) 272-9613
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009646
GA
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2123636
PK
—
05
—
951416911A
—
GA
Enumeration date
01/25/2010
Last updated
01/21/2020
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