Sun and Lake Pharmacy Services, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SUN AND LAKE PHARMACY SERVICES, INC

Practice address

1231 Lakeland Hills Blvd
Lakeland, FL 33805-4673

Phone

(863) 688-5427

Fax

(863) 688-5462

NPI assigned

Jan 30, 2007

Organization subpart

No

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

Authorized official

Name

Kwame Fosu, RPH

Title

Owner Pharmacist

Phone

(863) 688-5427

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• MEDICINE SHOPPE Doing business as

Locations

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1306982913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054673",
            "telephone_number": "863-688-5427",
            "fax_number": "863-688-5462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN AND LAKE PHARMACY SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "FOSU",
        "authorized_official_first_name": "KWAME",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "863-688-5427",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "FL",
            "license": "BP121476",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1013767",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030900100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICINE SHOPPE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Gruer Sullivan, LMHC, MCAP
• Kaitlyn Elizabeth Summers
• Karen Summers
• Summerville at Lakeland, LLC
• Summerwood Private Duty Services
• Danton Manabat Sun, MD
• William Ronald Sunailitus Jr., RN
• Sunburst Community Care - Lakeland Hills, LLC
• Suncoast Community Health Centers, Inc
• Suncoast Community Health Centers, Inc

• Community/Retail Pharmacy in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.