MEDICARE: SCOLARIS WAREHOUSE MARKETS 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	3316337	NV

General Provider Information

NPI Number	:	1548211279
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOLARIS WAREHOUSE MARKETS INC.

Provider Business Mailing Address
First Line	:	2375 ODDIE BLVD
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89512-2118
Country	:	US
Telephone Number	:	775-358-4337
Fax Number	:	775-358-9609

Provider Business Practice Location Address
First Line	:	2375 ODDIE BLVD
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89512-2118
Country	:	US
Telephone Number	:	775-358-4337
Fax Number	:	775-358-9609

Authorized Official
Title or Position	:	PHARMACY INSURANCE ADMINISTRATOR
Name	:	MR. ALMA D TREJO
Credential	:
Telephone Number	:	775-785-7396

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	09/23/2016

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