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General NPI Number Information
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NPI Number | 1487862611
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Entity Type | Individual
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Provider Name | SCOTT DAVIS NEALY PHARMACIST
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Gender | Male
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Dates
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Enumeration Date | 05/20/2007
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Last Update Date | 09/14/2011
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Provider Practice Location Address
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Address Line | 1508 BEGLIS PKWY
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City | SULPHUR
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State | LA
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Zip | 70663-5606
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Country | US
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Telephone | 337-625-2660
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Fax | 337-625-9812
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Provider Business Mailing Address
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Address Line | 2510 DIETZ ST
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City | LAKE CHARLES
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State | LA
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Zip | 70601-7236
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Country | US
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Telephone | 337-494-0718
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Fax | 337-494-0718
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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 | 31721
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 11172
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License Number State | LA
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