Provider Demographics
NPI:1437153343
Name:SCOTT, JAMES FARRELL (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:FARRELL
Last Name:SCOTT
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 1:5011 DOVE CT
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-7516
Mailing Address - Country:US
Mailing Address - Phone:563-332-6967
Mailing Address - Fax:
Practice Address - Street 1:1823 E KIMBERLY RD
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2027
Practice Address - Country:US
Practice Address - Phone:563-359-5313
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAS13768183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist