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Organization

SABRINA ENTERPRISES, INC.

Active
Other names
Dwaynes Friendly Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
DWAYNE NORTON WILSON R.PH. (OWNER/MANAGER)
(760) 872-2522
Entity
Organization

Contact information

Practice address
644 W LINE ST, BISHOP, CA 93514-3315
(760) 872-2497
(760) 872-3935
Mailing address
644 W LINE ST, BISHOP, CA 93514-3315
(760) 872-2497
(760) 872-3935

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHA35213
CA
3336L0003X
Long Term Care Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0589777
NCPDP NUMBER
01
FLU11421F
FLU PROVIDER #
CA
05
PHA352130
CA
Enumeration date
12/21/2005
Last updated
03/06/2025
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