MEDICARE: WRIVS 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	183500000X	Pharmacist	2366	WY
2	3336S0011X	Specialty Pharmacy
3	332B00000X	Durable Medical Equipment & Medical Supplies	52-02394	WY
4	3336H0001X	Home Infusion Therapy Pharmacy	52-02394	WY

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

General Provider Information

NPI Number	:	1902990633
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WRIVS INC

Provider Business Mailing Address
First Line	:	3131 E GRAND AVE UNIT B
Second Line	:
City	:	LARAMIE
State	:	WY
Zip	:	82070-5140
Country	:	US
Telephone Number	:	307-742-5048
Fax Number	:	307-745-0432

Provider Business Practice Location Address
First Line	:	3131 E GRAND AVE UNIT B
Second Line	:
City	:	LARAMIE
State	:	WY
Zip	:	82070-5140
Country	:	US
Telephone Number	:	307-742-5048
Fax Number	:	307-745-0432

Authorized Official
Title or Position	:	PHARMACIST-IN-CHARGE
Name	:	JENNA SCOZZAFAVA
Credential	:	PHARMD
Telephone Number	:	307-742-5048

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	01/27/2026

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Directions to “WRIVS INC ” Practice Location

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