| NPI | 1114312451 |
|---|---|
| Doing Business As | SUNNYSIDE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | TAMMIE MISKIMINS Mgr, Licensing & Third Party 817-572-0009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OR RP0003062CS) |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2016-06-29 |