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General NPI Number Information
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NPI Number | 1508202854
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Entity Type | Individual
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Provider Name | PHILIP SCOTT JOHNSON PHARMD
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Gender | Male
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Dates
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Enumeration Date | 05/14/2013
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Last Update Date | 05/14/2013
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Provider Practice Location Address
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Address Line | 1051 CLAYPOOL HILL MALL RD STE 1
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City | CEDAR BLUFF
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State | VA
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Zip | 24609-8201
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Country | US
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Telephone | 276-963-1067
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Fax | 276-964-6344
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Provider Business Mailing Address
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Address Line | 1 CLAYPOOL HILL MALL
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City | CEDAR BLUFF
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State | VA
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Zip | 24609
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Country | US
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Telephone | 276-963-1067
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Fax | 276-964-6344
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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 | 0202012259
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License Number State | VA
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