Provider Demographics
NPI:1578837118
Name:SAYBIAN ENTERPRISES, INC.
Entity Type:Organization
Organization Name:SAYBIAN ENTERPRISES, INC.
Other - Org Name:WARNER WEST PHARMACY & SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-883-9490
Mailing Address - Street 1:22030 SHERMAN WAY
Mailing Address - Street 2:STE 100
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-1855
Mailing Address - Country:US
Mailing Address - Phone:818-883-9490
Mailing Address - Fax:818-883-9493
Practice Address - Street 1:22030 SHERMAN WAY
Practice Address - Street 2:STE 100
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1855
Practice Address - Country:US
Practice Address - Phone:818-883-9490
Practice Address - Fax:818-883-9493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-29
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY 49208333600000X, 3336C0003X, 3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7147150001OtherMEDICARE
5643057OtherNCPDP PROVIDER IDENTIFICATION NUMBER
CACAOtherPHY 49208