MEDICARE: BIOSCRIP PHARMACY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	006064	MO
2	3336C0003X	Community/Retail Pharmacy	006064	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518960665
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIOSCRIP PHARMACY, INC.

Provider Business Mailing Address
First Line	:	14847 COLLECTION CENTER DR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60693-0148
Country	:	US
Telephone Number	:	800-753-5995
Fax Number	:	952-352-6698

Provider Business Practice Location Address
First Line	:	115A N. EUCLID AVE
Second Line	:
City	:	ST. LOUIS
State	:	MO
Zip	:	63108
Country	:	US
Telephone Number	:	314-454-6676
Fax Number	:	314-367-1881

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	JAMES MELANCON
Credential	:
Telephone Number	:	917-449-6939

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	12/03/2010

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Directions to “BIOSCRIP PHARMACY, INC. ” Practice Location

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