Provider Demographics
NPI:1629381017
Name:SCRIPTRX INC
Entity Type:Organization
Organization Name:SCRIPTRX INC
Other - Org Name:SCRIPTX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER / PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:VINODH
Authorized Official - Middle Name:
Authorized Official - Last Name:THAKUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-538-8100
Mailing Address - Street 1:72 E 167TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452-8203
Mailing Address - Country:US
Mailing Address - Phone:718-538-8100
Mailing Address - Fax:718-538-8118
Practice Address - Street 1:72 E 167TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-8203
Practice Address - Country:US
Practice Address - Phone:718-538-8100
Practice Address - Fax:718-538-8118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-14
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0304393336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5802497OtherNCPDP PROVIDER IDENTIFICATION NUMBER
NY03261016Medicaid
NY6529090001Medicare NSC