1871786715 NPI number — ACP SCRIPTLINK LLC

Table of content: (NPI 1871786715)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871786715 NPI number — ACP SCRIPTLINK LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACP SCRIPTLINK LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ACP PHARMACY AT ST LUKE'S
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871786715
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/02/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17350 ST LUKES WAY STE 150
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
THE WOODLANDS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77384-4172
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-602-3493
Provider Business Mailing Address Fax Number:
281-458-1889

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17350 ST LUKES WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
THE WOODLANDS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77384-4100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-602-3493
Provider Business Practice Location Address Fax Number:
936-242-1918
Provider Enumeration Date:
08/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BUI
Authorized Official First Name:
HUONG
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING OFFICER
Authorized Official Telephone Number:
832-275-1600

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 29595 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336C0004X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336S0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 145841 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2154143 . This is a "PK" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com