Provider Demographics
NPI:1003227638
Name:SCRIPT SHOP MIAMI LLC
Entity Type:Organization
Organization Name:SCRIPT SHOP MIAMI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-888-1601
Mailing Address - Street 1:1680 MICHIGAN AVE
Mailing Address - Street 2:800
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-2538
Mailing Address - Country:US
Mailing Address - Phone:888-888-1601
Mailing Address - Fax:
Practice Address - Street 1:1680 MICHIGAN AVE
Practice Address - Street 2:800
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-2538
Practice Address - Country:US
Practice Address - Phone:888-888-1601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-16
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL333600000X, 333600000X
3336C0003X, 3336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy