Healthcare Provider Details

I. General information

NPI: 1437153343
Provider Name (Legal Business Name): JAMES FARRELL SCOTT PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/08/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1823 E KIMBERLY RD
DAVENPORT IA
52807-2027
US

IV. Provider business mailing address

5011 DOVE CT
BETTENDORF IA
52722-7516
US

V. Phone/Fax

Practice location:
  • Phone: 563-359-5313
  • Fax:
Mailing address:
  • Phone: 563-332-6967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS13768
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: