Provider Demographics
NPI:1407536444
Name:SCRIPT HEALTH CLINICAL
Entity Type:Organization
Organization Name:SCRIPT HEALTH CLINICAL
Other - Org Name:SCRIPT HEALTH CLINICAL OF IDAHO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:LOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-227-9307
Mailing Address - Street 1:222 MERCHANDISE MART PLZ STE 1230
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-4342
Mailing Address - Country:US
Mailing Address - Phone:312-999-0154
Mailing Address - Fax:
Practice Address - Street 1:222 MERCHANDISE MART PLZ STE 1230
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-4342
Practice Address - Country:US
Practice Address - Phone:312-999-0154
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCRIPT HEALTH CLINICAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-24
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Single Specialty
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory CareGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty