Provider Demographics
NPI:1407228117
Name:SCAGGS, DON (RPH)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:
Last Name:SCAGGS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:DON
Other - Middle Name:
Other - Last Name:SCAGGS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:1455 E NOBLE AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93292-3042
Mailing Address - Country:US
Mailing Address - Phone:559-636-1603
Mailing Address - Fax:559-636-1537
Practice Address - Street 1:1455 E NOBLE AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93292-3042
Practice Address - Country:US
Practice Address - Phone:559-636-1603
Practice Address - Fax:559-636-1537
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-21
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261611835P0018X
CA26162183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA26162OtherPHARMCIST LICENSE
CA337366OtherNABP