Provider Demographics
NPI:1710336391
Name:SCRIPTDIRECT LLC
Entity Type:Organization
Organization Name:SCRIPTDIRECT LLC
Other - Org Name:SCRIPT DIRECT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:SOSKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-742-8694
Mailing Address - Street 1:5379 KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-6704
Mailing Address - Country:US
Mailing Address - Phone:718-475-1448
Mailing Address - Fax:718-475-1449
Practice Address - Street 1:5379 KINGS HWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-6704
Practice Address - Country:US
Practice Address - Phone:718-475-1448
Practice Address - Fax:718-475-1449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-06
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0345473336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2160440OtherPK