Healthcare Provider Details

I. General information

NPI: 1013098185
Provider Name (Legal Business Name): K. SCOT AIKEN R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 HWY. 31 NORTH
FULTONDALE AL
35068
US

IV. Provider business mailing address

3328 WISTERIA DR
VESTAVIA HILLS AL
35216-4260
US

V. Phone/Fax

Practice location:
  • Phone: 205-841-2021
  • Fax: 205-841-2425
Mailing address:
  • Phone: 205-823-8233
  • Fax: 205-823-9536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number12563
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: