Provider Demographics
NPI:1275543662
Name:SCOLARIS WAREHOUSE MARKETS INC.
Entity Type:Organization
Organization Name:SCOLARIS WAREHOUSE MARKETS INC.
Other - Org Name:SCOLARI'S FOOD & DRUG CO.115
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALMA
Authorized Official - Middle Name:D
Authorized Official - Last Name:TREJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-785-7396
Mailing Address - Street 1:176 W GOLDFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:YERINGTON
Mailing Address - State:NV
Mailing Address - Zip Code:89447-2394
Mailing Address - Country:US
Mailing Address - Phone:775-463-1933
Mailing Address - Fax:775-463-1734
Practice Address - Street 1:176 W GOLDFIELD AVE
Practice Address - Street 2:
Practice Address - City:YERINGTON
Practice Address - State:NV
Practice Address - Zip Code:89447-2394
Practice Address - Country:US
Practice Address - Phone:775-463-1933
Practice Address - Fax:775-463-1734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV33100080332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV3310080Medicaid