Provider Demographics
NPI:1073525259
Name:JAY S PARTON
Entity Type:Organization
Organization Name:JAY S PARTON
Other - Org Name:SCOTTS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:J
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:PARTON
Authorized Official - Suffix:
Authorized Official - Credentials:R PH
Authorized Official - Phone:903-342-3669
Mailing Address - Street 1:211 E COKE RD
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:TX
Mailing Address - Zip Code:75494-3213
Mailing Address - Country:US
Mailing Address - Phone:903-342-3669
Mailing Address - Fax:903-342-6120
Practice Address - Street 1:211 E COKE RD
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:TX
Practice Address - Zip Code:75494-3213
Practice Address - Country:US
Practice Address - Phone:903-342-3669
Practice Address - Fax:903-342-6120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0960570001332B00000X
TX162583336C0003X
3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1204030Medicaid
TXPH0346OtherMEDICARE, IMMUNIZATIONS
TX144190Medicaid
TX0960570001Medicare NSC