Provider Demographics
NPI:1003272071
Name:SAV-ON DRUG STORES INC
Entity Type:Organization
Organization Name:SAV-ON DRUG STORES INC
Other - Org Name:ZEN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-998-2991
Mailing Address - Street 1:16455 MAIN ST
Mailing Address - Street 2:STE 8
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-3554
Mailing Address - Country:US
Mailing Address - Phone:760-998-2991
Mailing Address - Fax:760-998-2994
Practice Address - Street 1:16455 MAIN ST STE 8
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-3500
Practice Address - Country:US
Practice Address - Phone:760-998-2991
Practice Address - Fax:760-998-2994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-06
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CAPHY541733336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2157632OtherPK
CA1003272071Medicaid