Healthcare Provider Details

I. General information

NPI: 1871833939
Provider Name (Legal Business Name): SCRIPT DEPOT LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2013
Last Update Date: 03/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1619 FRANKLIN RD BLDG A
YUBA CITY CA
95993-4609
US

IV. Provider business mailing address

1619 FRANKLIN RD BLDG A
YUBA CITY CA
95993-4609
US

V. Phone/Fax

Practice location:
  • Phone: 530-674-3277
  • Fax: 530-674-3664
Mailing address:
  • Phone: 530-674-3277
  • Fax: 530-674-3664

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 TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number54452
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KHALED SEDKI
Title or Position: CEO
Credential:
Phone: 530-674-3277