Healthcare Provider Details

I. General information

NPI: 1265226849
Provider Name (Legal Business Name): SCRIPTS 360 WELLNESS CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1540 MICHIGAN ST
SIDNEY OH
45365-2451
US

IV. Provider business mailing address

1540 MICHIGAN ST
SIDNEY OH
45365-2451
US

V. Phone/Fax

Practice location:
  • Phone: 469-915-4211
  • Fax: 937-658-6215
Mailing address:
  • Phone: 469-915-4211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AL BERRY
Title or Position: MANAGER
Credential:
Phone: 469-915-4211