Provider Demographics
NPI:1184676595
Name:WELLSCRIPT, INC.
Entity Type:Organization
Organization Name:WELLSCRIPT, INC.
Other - Org Name:WELLSCRIPT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIESEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-246-1075
Mailing Address - Street 1:PO BOX 992775
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96099-2775
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2025 COURT ST
Practice Address - Street 2:STE D
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1805
Practice Address - Country:US
Practice Address - Phone:530-225-8898
Practice Address - Fax:530-246-7366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336S0011X
CAPHY436333336H0001X
CAPHA4363303336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0596621OtherNCPDP PROVIDER IDENTIFICATION NUMBER
CAPHA436330Medicaid
0256530002Medicare NSC