Provider Demographics
NPI:1023039799
Name:CADY, SCOTT ALLEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ALLEN
Last Name:CADY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:MO
Mailing Address - Zip Code:64601
Mailing Address - Country:US
Mailing Address - Phone:660-240-0828
Mailing Address - Fax:660-707-0019
Practice Address - Street 1:504 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:MO
Practice Address - Zip Code:64601
Practice Address - Country:US
Practice Address - Phone:660-240-0828
Practice Address - Fax:660-707-0019
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006019794183500000X, 163WD0400X
KS1-14159183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO357208206OtherMEDICAID - MTM