Provider Demographics
NPI:1598012270
Name:GENSCRIPTS LLC
Entity Type:Organization
Organization Name:GENSCRIPTS LLC
Other - Org Name:GENSCRIPTS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-694-6221
Mailing Address - Street 1:3980 S HUDSON AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-5608
Mailing Address - Country:US
Mailing Address - Phone:918-828-9696
Mailing Address - Fax:918-828-9778
Practice Address - Street 1:4666 W HOUSTON ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-4635
Practice Address - Country:US
Practice Address - Phone:918-615-3330
Practice Address - Fax:918-615-3372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2-60073336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3726986OtherNCPDP PROVIDER IDENTIFICATION NUMBER