Healthcare Provider Details

I. General information

NPI: 1477654671
Provider Name (Legal Business Name): JL SCOTT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 ALEXANDER DR
DOTHAN AL
36302
US

IV. Provider business mailing address

2021 ALEXANDER DR PO BOX 849
DOTHAN AL
36302
US

V. Phone/Fax

Practice location:
  • Phone: 334-792-2717
  • Fax: 334-792-9408
Mailing address:
  • Phone: 334-792-2717
  • Fax: 334-792-9408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number111652
License Number StateAL

VIII. Authorized Official

Name: MR. JAMES LENDON SCOTT SR.
Title or Position: OWNER
Credential: RPH
Phone: 334-792-2717