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General NPI Number Information
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NPI Number | 1043665425
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Entity Type | Organization
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Legal Business Name | SCRIPPS HEALTH
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Dates
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Enumeration Date | 05/04/2016
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Last Update Date | 02/19/2020
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Provider Practice Location Address
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Address Line | 4060 4TH AVE. SUITE 110
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City | SAN DIEGO
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State | CA
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Zip | 92103-2116
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Country | US
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Telephone | 858-678-7111
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Fax | 858-678-6663
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Provider Business Mailing Address
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Address Line | 10790 RANCHO BERNARDO RD. 2ND FL.
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City | SAN DIEGO
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State | CA
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Zip | 92127-5705
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Country | US
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Telephone | 858-678-7111
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Fax | 858-678-6663
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Authorized Official
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Title or Position | EVP/CFO
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Name | MR. RICHARD ROTHBERGER
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Credential |
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Telephone | 858-678-6828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHY54317
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License Number State | CA
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