Provider Demographics
NPI:1477654671
Name:JL SCOTT INC
Entity Type:Organization
Organization Name:JL SCOTT INC
Other - Org Name:PHARMACEUTICAL COMPOUNDING CENTER OF DOTHAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LENDON
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:SR
Authorized Official - Credentials:RPH
Authorized Official - Phone:334-792-2717
Mailing Address - Street 1:2021 ALEXANDER DR
Mailing Address - Street 2:PO BOX 849
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36302
Mailing Address - Country:US
Mailing Address - Phone:334-792-2717
Mailing Address - Fax:334-792-9408
Practice Address - Street 1:2021 ALEXANDER DR
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36302
Practice Address - Country:US
Practice Address - Phone:334-792-2717
Practice Address - Fax:334-792-9408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL111652333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy