Provider Demographics
NPI:1013384437
Name:SCROGGINS, ASHLEY (PHARMD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:SCROGGINS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6129 W US HIGHWAY 60
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MO
Mailing Address - Zip Code:65619-9441
Mailing Address - Country:US
Mailing Address - Phone:417-708-5050
Mailing Address - Fax:417-708-5055
Practice Address - Street 1:6129 W US HIGHWAY 60
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MO
Practice Address - Zip Code:65619-9441
Practice Address - Country:US
Practice Address - Phone:417-708-5050
Practice Address - Fax:417-708-5055
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-02
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014026387183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2014026387OtherPHARMACIST LICENSE NUMBER FOR MISSOURI