Provider Demographics
NPI:1598194151
Name:MED SCRIPTS PHARMACY
Entity Type:Organization
Organization Name:MED SCRIPTS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ADETOWUN
Authorized Official - Middle Name:
Authorized Official - Last Name:BISIRIYU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-371-6100
Mailing Address - Street 1:10039 BISSONNET ST STE 116
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-7838
Mailing Address - Country:US
Mailing Address - Phone:832-371-6100
Mailing Address - Fax:
Practice Address - Street 1:10039 BISSONNET ST STE 116
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-7838
Practice Address - Country:US
Practice Address - Phone:832-371-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-04
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX146884Medicaid