Healthcare Provider Details

I. General information

NPI: 1164425120
Provider Name (Legal Business Name): BIOSCRIP PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 12/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2262 MARKET ST
SAN FRANCISCO CA
94114-1508
US

IV. Provider business mailing address

10050 CROSSTOWN CIR STE 300
EDEN PRAIRIE MN
55344-3374
US

V. Phone/Fax

Practice location:
  • Phone: 415-255-0101
  • Fax:
Mailing address:
  • Phone: 800-753-5995
  • Fax: 952-352-6698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY43522
License Number StateCA

VIII. Authorized Official

Name: JAMES MELANCON
Title or Position: VICE PRESIDENT
Credential:
Phone: 917-449-6939