Healthcare Provider Details

I. General information

NPI: 1750391140
Provider Name (Legal Business Name): SCOLARIS WAREHOUSE MARKETS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 09/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4788 CAUGHLIN PKWY
RENO NV
89509-0907
US

IV. Provider business mailing address

4788 CAUGHLIN PKWY
RENO NV
89509-0907
US

V. Phone/Fax

Practice location:
  • Phone: 775-828-2377
  • Fax: 775-828-9165
Mailing address:
  • Phone: 775-828-2377
  • Fax: 775-828-9165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number3316031
License Number StateNV

VIII. Authorized Official

Name: MR. ALMA D TREJO
Title or Position: PHARMACY INSURANCE ADMINISTRATOR
Credential:
Phone: 775-785-7396