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General NPI Number Information
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NPI Number | 1336125236
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Entity Type | Organization
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Legal Business Name | SABRINA ENTERPRISES, INC.
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Dates
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Enumeration Date | 12/21/2005
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 644 W LINE ST
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City | BISHOP
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State | CA
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Zip | 93514-3315
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Country | US
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Telephone | 760-872-2497
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Fax | 760-872-3935
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Provider Business Mailing Address
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Address Line | 644 W LINE ST
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City | BISHOP
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State | CA
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Zip | 93514-3315
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Country | US
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Telephone | 760-872-2497
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Fax | 760-872-3935
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | DWAYNE NORTON WILSON
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Credential | R.PH.
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Telephone | 760-872-2522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHA35213
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License Number State | CA
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