Healthcare Provider Details

I. General information

NPI: 1336159730
Provider Name (Legal Business Name): SCOLARI'S #28 PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6255 SHARLANDS AVE
RENO NV
89523-2785
US

IV. Provider business mailing address

6255 SHARLANDS AVE
RENO NV
89523-2785
US

V. Phone/Fax

Practice location:
  • Phone: 775-746-7311
  • Fax: 775-746-7315
Mailing address:
  • Phone: 775-746-7311
  • Fax: 775-746-7315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number2907256
License Number StateNV

VIII. Authorized Official

Name: MRS. ANGIE SHARP
Title or Position: PHARMACY INSURANCE ADMINISTRATOR
Credential:
Phone: 775-356-2558