Provider Demographics
NPI:1467845008
Name:CHRISTY, SCOTT (PHARMD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:CHRISTY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3381 VALLEY CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-9195
Mailing Address - Country:US
Mailing Address - Phone:336-543-8811
Mailing Address - Fax:
Practice Address - Street 1:300 E CORNWALLIS DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-5104
Practice Address - Country:US
Practice Address - Phone:336-275-9471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18175183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist