MEDICARE: FILLASCRIPT 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	3336C0003X	Community/Retail Pharmacy	26170	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4549715	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1962652396
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FILLASCRIPT INC

Provider Business Mailing Address
First Line	:	3010 S RICHEY ST
Second Line	:	STE C
City	:	HOUSTON
State	:	TX
Zip	:	77017-7220
Country	:	US
Telephone Number	:	713-401-3536
Fax Number	:	713-943-9696

Provider Business Practice Location Address
First Line	:	3010 S RICHEY ST
Second Line	:	STE C
City	:	HOUSTON
State	:	TX
Zip	:	77017-7220
Country	:	US
Telephone Number	:	713-401-3536
Fax Number	:	713-943-9696

Authorized Official
Title or Position	:	PIC
Name	:	DANIELLE NGUYEN
Credential	:
Telephone Number	:	832-875-5735

Provider Enumeration Date	:	09/23/2008
Last Update Date	:	12/31/2012

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Directions to “FILLASCRIPT INC ” Practice Location

Language	Start Address	Practice Location

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