Provider Demographics
NPI:1053800052
Name:SINA DRUG LLC
Entity type:Organization
Organization Name:SINA DRUG LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RANDOLPH
Authorized Official - Middle Name:
Authorized Official - Last Name:FALKENRATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-662-6633
Mailing Address - Street 1:13410 EASTPOINT CENTRE DR
Mailing Address - Street 2:STE 101
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:502-849-0643
Practice Address - Street 1:10204 WERCH DR STE 302
Practice Address - Street 2:
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517
Practice Address - Country:US
Practice Address - Phone:877-662-6633
Practice Address - Fax:502-849-0643
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ONCO360
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-04
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy