Provider Demographics
NPI:1255336517
Name:SCOTT-WILSON, INC.
Entity type:Organization
Organization Name:SCOTT-WILSON, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-879-6137
Mailing Address - Street 1:4222 PAYSPHERE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-0042
Mailing Address - Country:US
Mailing Address - Phone:800-879-6137
Mailing Address - Fax:
Practice Address - Street 1:2380 FORTUNE DRIVE
Practice Address - Street 2:SUITE 130
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509
Practice Address - Country:US
Practice Address - Phone:859-277-2013
Practice Address - Fax:859-277-9698
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIOSCRIP, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-14
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251F00000XAgenciesHome Infusion
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1819905OtherNCPDP
KYP07292OtherLICENSE
KYP07292OtherLICENSE
KYP07292OtherLICENSE
KYP07292OtherLICENSE
WVMO0560413OtherLICENSE
KY7100065790Medicaid