Organization
SUNRISE PHARMACY LLC
Active
Other names
Lauderdale Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLUWOLE AYOTUNDE OLUMIDE PHARMD (PHARMACY MANAGER)
(954) 530-7171
Entity
Organization
Contact information
Practice address
4000 N STATE ROAD 7, SUITE 103, LAUDERDALE LAKES, FL 33319-4804
(954) 530-7171
(954) 440-4180
Mailing address
4000 N STATE ROAD 7, SUITE 103, LAUDERDALE LAKES, FL 33319-4804
(954) 530-7171
(954) 440-4180
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH28385
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012965100
—
FL
Enumeration date
08/05/2014
Last updated
09/01/2021
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