Provider Demographics
NPI:1477981512
Name:SCOTT'S QUITMAN PHARMACY, LLC
Entity Type:Organization
Organization Name:SCOTT'S QUITMAN PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:PARTON
Authorized Official - Suffix:
Authorized Official - Credentials:R PH
Authorized Official - Phone:903-342-6664
Mailing Address - Street 1:310 E. GOODE ST.
Mailing Address - Street 2:SUITE E
Mailing Address - City:QUITMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75783
Mailing Address - Country:US
Mailing Address - Phone:903-763-9600
Mailing Address - Fax:903-763-8237
Practice Address - Street 1:310 E GOODE ST
Practice Address - Street 2:
Practice Address - City:QUITMAN
Practice Address - State:TX
Practice Address - Zip Code:75783-2535
Practice Address - Country:US
Practice Address - Phone:903-763-9600
Practice Address - Fax:903-763-8237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7412570001Medicare NSC