Healthcare Provider Details

I. General information

NPI: 1639528847
Provider Name (Legal Business Name): AMBER ENTERPRISES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2016
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 COMMERCIAL RD UNIT 102103
SAN BERNARDINO CA
92408-3765
US

IV. Provider business mailing address

10004 S 152ND ST STE A
OMAHA NE
68138-3931
US

V. Phone/Fax

Practice location:
  • Phone: 888-370-1724
  • Fax:
Mailing address:
  • Phone: 402-896-5000
  • Fax: 402-896-3774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SEAN LYSINGER
Title or Position: VP, CFO, PHARMACY
Credential:
Phone: 412-400-1809