Provider Demographics
NPI:1316012990
Name:SYD'S PHARMACY INC
Entity Type:Organization
Organization Name:SYD'S PHARMACY INC
Other - Org Name:SYD'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-933-8571
Mailing Address - Street 1:7111 BEVERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-2538
Mailing Address - Country:US
Mailing Address - Phone:323-933-8571
Mailing Address - Fax:323-933-7370
Practice Address - Street 1:7111 BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-2538
Practice Address - Country:US
Practice Address - Phone:323-933-8571
Practice Address - Fax:323-933-7370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA506983336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0536916OtherNCPDP PROVIDER IDENTIFICATION NUMBER