Provider Demographics
NPI:1114937364
Name:SCOLARI'S #23 PHARMACY
Entity Type:Organization
Organization Name:SCOLARI'S #23 PHARMACY
Other - Org Name:SCOLARI'S FOOD & DRUG CO.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY INSURANCE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-356-2558
Mailing Address - Street 1:1329 HWY. 395 SOUTH
Mailing Address - Street 2:SUITE 12
Mailing Address - City:GARDNERVILLE
Mailing Address - State:NV
Mailing Address - Zip Code:89410
Mailing Address - Country:US
Mailing Address - Phone:775-782-5530
Mailing Address - Fax:775-782-5592
Practice Address - Street 1:1329 HWY. 395 SOUTH
Practice Address - Street 2:SUITE 12
Practice Address - City:GARDNERVILLE
Practice Address - State:NV
Practice Address - Zip Code:89410
Practice Address - Country:US
Practice Address - Phone:775-782-5530
Practice Address - Fax:775-782-5592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3303525332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV3303525Medicaid