Healthcare Provider Details

I. General information

NPI: 1801452982
Provider Name (Legal Business Name): PHARMASCRIPT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2019
Last Update Date: 05/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6170 N DURANGO DR # 250
LAS VEGAS NV
89149-3926
US

IV. Provider business mailing address

5437 N BROADWAY ST
CHICAGO IL
60640-1703
US

V. Phone/Fax

Practice location:
  • Phone: 702-701-8781
  • Fax: 702-701-8782
Mailing address:
  • Phone: 844-635-3221
  • Fax: 774-961-8907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LANRE A SHOMADE
Title or Position: PRESIDENT & SECRETARY
Credential:
Phone: 773-275-8390