Provider Demographics
NPI:1073882502
Name:SAMMONS, SCARLETT V (PHARMD)
Entity Type:Individual
Prefix:
First Name:SCARLETT
Middle Name:V
Last Name:SAMMONS
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 1:7932 17TH WAY N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-3945
Mailing Address - Country:US
Mailing Address - Phone:727-374-6828
Mailing Address - Fax:
Practice Address - Street 1:4401 GULF BLVD
Practice Address - Street 2:
Practice Address - City:ST PETE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33706-3832
Practice Address - Country:US
Practice Address - Phone:727-367-7754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-29
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41732183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist