Provider Demographics
NPI:1841226040
Name:ELDERSCRIPT SERVICES LLC
Entity Type:Organization
Organization Name:ELDERSCRIPT SERVICES LLC
Other - Org Name:ELDERSCRIPT SVCS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:662-842-6204
Mailing Address - Street 1:146 S THOMAS ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-5328
Mailing Address - Country:US
Mailing Address - Phone:662-842-6204
Mailing Address - Fax:662-842-6205
Practice Address - Street 1:146 S THOMAS ST
Practice Address - Street 2:SUITE A
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-5328
Practice Address - Country:US
Practice Address - Phone:662-842-6204
Practice Address - Fax:662-842-6205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-23
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS069570233336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2047293OtherPK