Provider Demographics
NPI:1023566205
Name:ALLYSCRIPTS LLC
Entity Type:Organization
Organization Name:ALLYSCRIPTS LLC
Other - Org Name:ALLYSCRIPTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMBS
Authorized Official - Phone:256-218-5513
Mailing Address - Street 1:201 LONNIE E CRAWFORD BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SCOTTSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35769
Mailing Address - Country:US
Mailing Address - Phone:256-218-5513
Mailing Address - Fax:844-309-7173
Practice Address - Street 1:201 LONNIE E CRAWFORD BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35769
Practice Address - Country:US
Practice Address - Phone:256-218-5513
Practice Address - Fax:844-309-7173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-15
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X, 3336M0002X, 3336S0011X
FLPH308983336C0003X
KYAL23313336C0003X
IA48843336C0003X
MTPHAMOPLIC462473336C0003X
ID44258MS3336C0003X
IL054.0202343336C0003X
GAPHNR0012333336C0003X
MO20170059473336C0003X
IN64002299A3336C0003X
MN2652033336C0003X
MS15313/7.13336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2164216OtherPK