Organization
SINA DRUG LLC
Active
Other names
ONCO360
Organization subpart
No
Provider details
NPI number
Authorized official
RANDOLPH FALKENRATH (PRESIDENT)
(877) 662-6633
Entity
Organization
Contact information
Practice address
1985 MARCUS AVE STE 120, NEW HYDE PARK, NY 11042-2024
(877) 662-6633
(877) 662-6355
Mailing address
13410 EASTPOINT CENTRE DR, STE 101, LOUISVILLE, KY 40223-4160
(877) 662-6633
(877) 662-6355
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
25289
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02317393
—
NY
01
—
25289
PHARMACY PERMIT
NY
Enumeration date
11/23/2016
Last updated
04/07/2021
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