Provider Demographics
NPI:1053615567
Name:SCRIPT CHOICE PHARMACY LLC
Entity type:Organization
Organization Name:SCRIPT CHOICE PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:MINH DOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-374-9944
Mailing Address - Street 1:18611 LE DAUPHINE PL
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-2886
Mailing Address - Country:US
Mailing Address - Phone:813-263-9055
Mailing Address - Fax:813-600-5565
Practice Address - Street 1:1721 W FLETCHER AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-1820
Practice Address - Country:US
Practice Address - Phone:813-374-9944
Practice Address - Fax:813-374-9945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH251373336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5703358OtherNCPDP PROVIDER IDENTIFICATION NUMBER