Organization
TINUMALA PHARMACY P C
Active
Other names
sunrise discount pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
NAGESH SHAKHAMOORI (PRESIDENT)
(407) 343-4434
Entity
Organization
Contact information
Practice address
4543 PLEASANT HILL RD, STE D & E, KISSIMMEE, FL 34759-3403
(407) 343-4434
(407) 574-8790
Mailing address
4543 PLEASANT HILL RD, STE D & E, KISSIMMEE, FL 34759-3403
(407) 343-4434
(407) 574-8790
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH25518
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003867000
—
FL
01
—
2153452
PK
—
Enumeration date
06/15/2011
Last updated
05/05/2016
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