Provider Demographics
NPI:1629338181
Name:BIO SCRIPT INC
Entity Type:Organization
Organization Name:BIO SCRIPT INC
Other - Org Name:BIO SCRIPT PHARMACY & SURGICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NERIK
Authorized Official - Middle Name:
Authorized Official - Last Name:ILYAYEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-576-3626
Mailing Address - Street 1:6049 FRESH POND RD
Mailing Address - Street 2:
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-3541
Mailing Address - Country:US
Mailing Address - Phone:718-576-3626
Mailing Address - Fax:718-576-3627
Practice Address - Street 1:6049 FRESH POND RD
Practice Address - Street 2:
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-3541
Practice Address - Country:US
Practice Address - Phone:718-576-3626
Practice Address - Fax:718-576-3627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-18
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031277333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
6693910001OtherMEDICARE PTAN
6693910001Medicare NSC