Provider Demographics
NPI:1457636045
Name:SCOTT, REBECCA JOYCE (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:JOYCE
Last Name:SCOTT
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 1:36TH MEDICAL GROUP
Mailing Address - Street 2:UNIT 14010 BLDG 26001
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96543
Mailing Address - Country:US
Mailing Address - Phone:671-366-5271
Mailing Address - Fax:
Practice Address - Street 1:36TH MEDICAL GROUP
Practice Address - Street 2:UNIT 14010 BLDG 26001
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96543
Practice Address - Country:US
Practice Address - Phone:671-366-5271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-15
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38450183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist