Provider Demographics
NPI:1982845855
Name:QUICK SCRIPT PHARMACY INC
Entity Type:Organization
Organization Name:QUICK SCRIPT PHARMACY INC
Other - Org Name:QUICK SCRIPT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / PRESIDENT / PIC
Authorized Official - Prefix:
Authorized Official - First Name:HUSSEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FAWAZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:954-514-7685
Mailing Address - Street 1:2408 WILTON DR
Mailing Address - Street 2:
Mailing Address - City:WILTON MANORS
Mailing Address - State:FL
Mailing Address - Zip Code:33305-1251
Mailing Address - Country:US
Mailing Address - Phone:954-514-7685
Mailing Address - Fax:954-514-7687
Practice Address - Street 1:2408 WILTON DR
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33305-1251
Practice Address - Country:US
Practice Address - Phone:954-514-7685
Practice Address - Fax:954-514-7687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-23
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH241923336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2119540OtherPK
FL001362400Medicaid