I initially ignored calls from this number, since 416 is an Ontario area code and I life in NY state. After looking at this website I concluded this was a spam or unwanted call. However, the company ended up leaving a message on a subsequent reply. They were a legitimate US drug company with a headquarters in the US. However, they were following up with me regarding some medicine I was on from an office in Ontario that handles the specifics of my inquiry. They use an international calling card to call around the world. This is just the number that shows up on caller ID. So, if you get a call from this number, it could be one of a number of callers from Canada, legit or otherwise.