Provider Demographics
NPI:1043352941
Name:J L SCOTT INC
Entity Type:Organization
Organization Name:J L SCOTT INC
Other - Org Name:CIRCLE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLEOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-792-2717
Mailing Address - Street 1:PO BOX 849
Mailing Address - Street 2:2021 ALEXANDER DR
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36302-0849
Mailing Address - Country:US
Mailing Address - Phone:334-792-2717
Mailing Address - Fax:334-792-7917
Practice Address - Street 1:2021 ALEXANDER DR
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-3003
Practice Address - Country:US
Practice Address - Phone:334-792-2717
Practice Address - Fax:334-792-7917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL102375332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000052527Medicaid
AL51052527OtherBCBS
AL000052527Medicaid
AL0258290001Medicare NSC