Provider Demographics
NPI:1932476728
Name:SINUTOPIC INC
Entity Type:Organization
Organization Name:SINUTOPIC INC
Other - Org Name:SINUS DYNAMICS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-552-7579
Mailing Address - Street 1:755 LAKEFIELD RD
Mailing Address - Street 2:STE D
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-2622
Mailing Address - Country:US
Mailing Address - Phone:805-777-7800
Mailing Address - Fax:888-414-0666
Practice Address - Street 1:755 LAKEFIELD RD
Practice Address - Street 2:STE D
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2622
Practice Address - Country:US
Practice Address - Phone:805-777-7800
Practice Address - Fax:888-414-0666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-21
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY508123336C0003X
3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2133370OtherPK