Provider Demographics
NPI:1417905902
Name:WHEELDON, SCOTT GRIERSON (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:GRIERSON
Last Name:WHEELDON
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8267 SWEET WATER RD
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-3018
Mailing Address - Country:US
Mailing Address - Phone:303-792-3929
Mailing Address - Fax:303-792-5152
Practice Address - Street 1:8267 SWEET WATER RD
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-3018
Practice Address - Country:US
Practice Address - Phone:303-792-3929
Practice Address - Fax:303-792-5152
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11772183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist