NPIMap

Organization Active NPI

Sunset Pharmacy LLC

  • Community/Retail Pharmacy
  • Fort Myers, FL
National Provider Identifier
1194024406
Registry record updated Mar 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH 24933 Issued in FL
Legal business name
SUNSET PHARMACY LLC
Doing business as
Sunset Pharmacy
Practice address
4224 Cleveland Ave Ste 5
Fort Myers, FL 33901-9051
Phone
(239) 225-6337
Fax
(239) 437-6337
NPI assigned
Mar 25, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Walter Klukowski
Title
Pharmacist
Phone
(239) 225-6337

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PH 24933 FL Primary

Addresses

Primary practice location

4224 Cleveland Ave Ste 5
Fort Myers, FL 33901-9051

Mailing address

4224 Cleveland Ave Ste 5
Fort Myers, FL 33901-9051
Phone (239) 225-6337

Other identifiers 1

IdentifierTypeStateIssuer
5704920OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • Sunset Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sunset Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4224 Cleveland Ave
Ste 5
Fort Myers, FL 33901
Phone (239) 225-6337

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301443200000",
    "number": "1194024406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4224 CLEVELAND AVE STE 5",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019051",
            "telephone_number": "239-225-6337",
            "fax_number": "239-437-6337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4224 CLEVELAND AVE STE 5",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019051",
            "telephone_number": "239-225-6337",
            "fax_number": "239-437-6337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSET PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-25",
        "last_updated": "2011-03-30",
        "status": "A",
        "authorized_official_last_name": "KLUKOWSKI",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "239-225-6337"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH 24933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5704920",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunset Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.