Healthcare Provider Details

I. General information

NPI: 1679488639
Provider Name (Legal Business Name): ANSLEY BROOKE SCOTT RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5421 NEW JESUP HWY
BRUNSWICK GA
31523-1119
US

IV. Provider business mailing address

3301 FAIRBURN CT
BLOOMINGDALE GA
31302-9713
US

V. Phone/Fax

Practice location:
  • Phone: 912-264-1321
  • Fax:
Mailing address:
  • Phone: 912-403-1570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH036277
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: