Provider Demographics
NPI:1275245870
Name:SINA DRUG LLC
Entity Type:Organization
Organization Name:SINA DRUG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:KONAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-689-4366
Mailing Address - Street 1:13410 EASTPOINT CENTRE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4160
Mailing Address - Country:US
Mailing Address - Phone:877-662-6633
Mailing Address - Fax:877-662-6533
Practice Address - Street 1:15990 N GREENWAY HAYDEN LOOP STE D100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2269
Practice Address - Country:US
Practice Address - Phone:877-662-6633
Practice Address - Fax:877-662-6533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-15
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy