Healthcare Provider Details

I. General information

NPI: 1306351994
Provider Name (Legal Business Name): JILL SCOLES PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2017
Last Update Date: 12/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 N AIRPORT RD
JASPER AL
35504-7068
US

IV. Provider business mailing address

1600 SHADES CLIFF RD
JASPER AL
35504-9136
US

V. Phone/Fax

Practice location:
  • Phone: 205-221-4564
  • Fax: 205-221-4555
Mailing address:
  • Phone: 205-585-4270
  • Fax: 205-221-4555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14864
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: