Provider Demographics
NPI:1316437775
Name:SPOT SCRIPT INC
Entity type:Organization
Organization Name:SPOT SCRIPT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:CALEB
Authorized Official - Middle Name:
Authorized Official - Last Name:GODING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-540-6390
Mailing Address - Street 1:109 E 17TH ST STE 25
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-4548
Mailing Address - Country:US
Mailing Address - Phone:800-540-6390
Mailing Address - Fax:
Practice Address - Street 1:1155 F ST NW STE 1050
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20004
Practice Address - Country:US
Practice Address - Phone:800-540-6930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-11
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTPME.0010170OtherDEPARTMENT OF CONSUMER PROTECTION