Provider Demographics
NPI:1073899712
Name:HILL, SCOTT
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 218
Mailing Address - Street 2:
Mailing Address - City:PINEVIEW
Mailing Address - State:GA
Mailing Address - Zip Code:31071-0218
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:117 COMMERCE ST E
Practice Address - Street 2:
Practice Address - City:PINEVIEW
Practice Address - State:GA
Practice Address - Zip Code:31071-3444
Practice Address - Country:US
Practice Address - Phone:229-624-2711
Practice Address - Fax:229-624-2811
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-26
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11580183500000X
GA22175183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist