Healthcare Provider Details

I. General information

NPI: 1346431681
Provider Name (Legal Business Name): JULIE LYNNE SCOTT PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JULIE LYNNE TOLLE PHARMD

II. Dates (important events)

Enumeration Date: 08/01/2007
Last Update Date: 02/02/2021
Certification Date: 02/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 PROFESSIONAL LN
ENTERPRISE AL
36330-2085
US

IV. Provider business mailing address

350 N ROPE PL
SISTERS OR
97759-5008
US

V. Phone/Fax

Practice location:
  • Phone: 334-348-9200
  • Fax: 334-348-9003
Mailing address:
  • Phone: 336-543-4957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number16408
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number0017934
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: