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General NPI Number Information
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NPI Number | 1235783416
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Entity Type | Individual
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Provider Name | KRISTEN SCOTT PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/26/2019
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Last Update Date | 07/26/2019
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Provider Practice Location Address
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Address Line | 119 W BOYCE ST
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City | MANNING
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State | SC
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Zip | 29102-3002
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Country | US
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Telephone | 803-435-8804
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Fax |
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Provider Business Mailing Address
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Address Line | 612 PASDALUM CT
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City | CHARLESTON
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State | SC
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Zip | 29414-7990
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Country | US
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Telephone | 843-637-0616
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 42096
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License Number State | SC
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