Provider Demographics
NPI:1265773501
Name:SAINT PAUL ENTERPRISES, INC.
Entity type:Organization
Organization Name:SAINT PAUL ENTERPRISES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MAGED
Authorized Official - Middle Name:
Authorized Official - Last Name:GINDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-962-1061
Mailing Address - Street 1:1010 E ARROW HWY
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91724-1020
Mailing Address - Country:US
Mailing Address - Phone:626-209-8169
Mailing Address - Fax:626-209-8171
Practice Address - Street 1:1010 E ARROW HWY
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91724-1020
Practice Address - Country:US
Practice Address - Phone:626-209-8169
Practice Address - Fax:626-209-8171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-12
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336H0001X, 3336S0011X, 333600000X
CAPHY554073336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2139300OtherPK