Sun Pharma LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

29858 Issued in TX

Legal business name

SUN PHARMA LLC

Practice address

2829 Babcock Rd Ste 120
San Antonio, TX 78229-6009

Phone

(210) 617-4311

Fax

(210) 617-4312

NPI assigned

Mar 25, 2015

Organization subpart

No

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

Authorized official

Name

Gangadhar RevuluriNPI 1174755995

Title

Owner / Pic

Phone

(910) 574-3002

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Galaxy Specialty Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gangadhar Revuluri, PHARMACIST

  • Pharmacist
  • San Antonio, TX
  • NPI 1174755995
  NPD Authorized official

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689897600000",
    "number": "1629462932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 BABCOCK RD STE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782296009",
            "telephone_number": "210-617-4311",
            "fax_number": "210-617-4312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2829 BABCOCK RD STE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782296009",
            "telephone_number": "210-617-4311",
            "fax_number": "210-617-4312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN PHARMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-25",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A",
        "authorized_official_last_name": "REVULURI",
        "authorized_official_first_name": "GANGADHAR",
        "authorized_official_title_or_position": "OWNER / PIC",
        "authorized_official_telephone_number": "910-574-3002"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "29858",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2149470",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Galaxy Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Galaxy Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marlene Mendicino Sumner, DDS
• Zachary Sumner, DO
• Sumoto Muto Mobility, Inc
• Erin Sumrall
• Sun Clinical Laboratory LLC
• Sun Psychological
• Alex Sun
• Derrick Yuan Sun, M.D.
• Hector Mauricio Suncin, MD
• Suncrest Hospice San Antonio LLC

• Community/Retail Pharmacy in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.