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General NPI Number Information
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NPI Number | 1457729030
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Entity Type | Individual
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Provider Name | MICHAEL SCOTT CHAMBLESS RPH
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Gender | Male
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Dates
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Enumeration Date | 09/12/2015
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Last Update Date | 09/12/2015
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Provider Practice Location Address
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Address Line | 1080 EASTERN BLVD
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City | MONTGOMERY
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State | AL
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Zip | 36117-1919
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Country | US
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Telephone | 334-277-5454
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Fax |
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Provider Business Mailing Address
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Address Line | 8801 WELLSTON PL
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City | MONTGOMERY
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State | AL
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Zip | 36117-8411
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Country | US
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Telephone | 334-271-0516
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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 | 11805
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License Number State | AL
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