Active NPI
Script Depot LP
- Pharmacy
- Yuba City, CA
National Provider Identifier
1922290097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 54491
- Legal business name
- SCRIPT DEPOT LP
- Practice address
- 866 Plumas St
Ste C
Yuba City, CA 95991-4022 - Phone
- (530) 751-1889
- Fax
- (530) 674-3698
- NPI assigned
- Aug 13, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Khaled Sedki
- Title
- President & Ceo
- Phone
- (248) 790-2786
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 54491 | CA | Primary |
| Community/Retail Pharmacy | 3336C0003X | |||
| Compounding Pharmacy | 3336C0004X | |||
| Long Term Care Pharmacy | 3336L0003X |
Addresses
Primary practice location
866 Plumas St
Ste C
Yuba City, CA 95991-4022
Mailing address
866 Plumas St
Ste C
Yuba City, CA 95991-4022
Phone (530) 751-1889
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2164032 | Other | PK |
Other names 1
- Riverside Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170526001100 | CA | Part B Supplier - Mass Immunization (Roster Biller Only) | 2062794183 |
1 other NPI on this enrollment Practice locations: Yuba City, CA |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186963200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1486425600000",
"number": "1922290097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "866 PLUMAS ST",
"address_2": "STE C",
"city": "YUBA CITY",
"state": "CA",
"postal_code": "959914022",
"telephone_number": "530-751-1889",
"fax_number": "530-674-3698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "866 PLUMAS ST",
"address_2": "STE C",
"city": "YUBA CITY",
"state": "CA",
"postal_code": "959914022",
"telephone_number": "530-751-1889",
"fax_number": "530-674-3698"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SCRIPT DEPOT LP",
"organizational_subpart": "NO",
"enumeration_date": "2007-08-13",
"last_updated": "2017-02-07",
"status": "A",
"authorized_official_last_name": "SEDKI",
"authorized_official_first_name": "KHALED",
"authorized_official_title_or_position": "PRESIDENT & CEO",
"authorized_official_telephone_number": "248-790-2786"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "CA",
"license": "54491",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0004X",
"taxonomy_group": "",
"desc": "Pharmacy, Compounding Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2164032",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Riverside Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Yuba City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.