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General NPI Number Information
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NPI Number | 1467734418
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Entity Type | Individual
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Provider Name | SAMANTHA MARIE SCOGN RPH
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Gender | Female
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Dates
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Enumeration Date | 09/15/2011
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Last Update Date | 09/15/2011
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Provider Practice Location Address
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Address Line | 17811 E US HIGHWAY 24
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City | INDEPENDENCE
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State | MO
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Zip | 64056-1164
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Country | US
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Telephone | 816-257-5202
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Fax | 816-257-1309
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Provider Business Mailing Address
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Address Line | 15600 E 3RD STREET CT S
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City | INDEPENDENCE
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State | MO
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Zip | 64050-2299
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Country | US
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Telephone | 816-679-4634
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Fax | 816-257-1309
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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 | 044472
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License Number State | MO
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