Healthcare Provider Details

I. General information

NPI: 1932476728
Provider Name (Legal Business Name): SINUTOPIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2011
Last Update Date: 03/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 LAKEFIELD RD STE D
WESTLAKE VILLAGE CA
91361-2622
US

IV. Provider business mailing address

755 LAKEFIELD RD STE D
WESTLAKE VILLAGE CA
91361-2622
US

V. Phone/Fax

Practice location:
  • Phone: 805-777-7800
  • Fax: 888-414-0666
Mailing address:
  • Phone: 805-777-7800
  • Fax: 888-414-0666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY50812
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MIKE SHAFER
Title or Position: CONTROLLER
Credential:
Phone: 805-552-7579