Provider Demographics
NPI: | 1124775267 |
---|---|
Name: | SCRIPT HEALTH CLINICAL |
Entity type: | Organization |
Organization Name: | SCRIPT HEALTH CLINICAL |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JAMES |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | LOTT |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 425-227-9307 |
Mailing Address - Street 1: | 222 MERCHANDISE MART PLZ STE 1230 |
Mailing Address - Street 2: | |
Mailing Address - City: | CHICAGO |
Mailing Address - State: | IL |
Mailing Address - Zip Code: | 60654-4342 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 312-999-0154 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 447 SUTTER ST STE 405 |
Practice Address - Street 2: | |
Practice Address - City: | SAN FRANCISCO |
Practice Address - State: | CA |
Practice Address - Zip Code: | 94108-4618 |
Practice Address - Country: | US |
Practice Address - Phone: | 312-999-0154 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2022-03-08 |
Last Update Date: | 2023-08-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 183500000X | Pharmacy Service Providers | Pharmacist | Group - Single Specialty | |
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Single Specialty |