Provider Demographics
NPI:1194127639
Name:SCRIPT SPECIALISTS
Entity type:Organization
Organization Name:SCRIPT SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWENER
Authorized Official - Prefix:
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GEGENHEIMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-792-4377
Mailing Address - Street 1:1922 HIGHWAY 22 W
Mailing Address - Street 2:SUITE B
Mailing Address - City:MADISONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70447-9490
Mailing Address - Country:US
Mailing Address - Phone:985-792-4377
Mailing Address - Fax:
Practice Address - Street 1:1922 HWY 22 WEST
Practice Address - Street 2:SUITE B
Practice Address - City:MADISONVILLE
Practice Address - State:LA
Practice Address - Zip Code:70447
Practice Address - Country:US
Practice Address - Phone:985-792-4377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0069513336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy