Organization
SUNSET PHARMACY LLC
Active
Other names
Sunset Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
COURTLAND TWYMAN (MANING PARTNER)
(239) 225-6337
Entity
Organization
Contact information
Practice address
4224 CLEVELAND AVE STE 5, FIRST FLOOR, FORT MYERS, FL 33901-9051
(239) 225-6337
(239) 437-6337
Mailing address
4224 CLEVELAND AVE STE 5, FORT MYERS, FL 33901-9051
(239) 225-6337
(239) 437-6337
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PH 24933
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003508600
—
FL
01
—
5708966
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/03/2012
Last updated
03/20/2012
Update your record
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