Provider Demographics
NPI:1154312254
Name:CLEAR SCRIPT COMPANY INC
Entity Type:Organization
Organization Name:CLEAR SCRIPT COMPANY INC
Other - Org Name:MORANS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GURINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:GREWAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-994-6440
Mailing Address - Street 1:PO BOX 7070
Mailing Address - Street 2:
Mailing Address - City:CLEARLAKE
Mailing Address - State:CA
Mailing Address - Zip Code:95422-7070
Mailing Address - Country:US
Mailing Address - Phone:707-994-6440
Mailing Address - Fax:707-944-8425
Practice Address - Street 1:15175 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:CLEARLAKE
Practice Address - State:CA
Practice Address - Zip Code:95422-8106
Practice Address - Country:US
Practice Address - Phone:707-994-6440
Practice Address - Fax:707-994-8425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-30
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY467323336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2035733OtherPK
CAPHA467320Medicaid
5481630001Medicare NSC