Provider Demographics
NPI:1508053646
Name:POPYK, SCOTT (RPH)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:POPYK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39303 COUNTRY CLUB DRIVE
Mailing Address - Street 2:A26
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331
Mailing Address - Country:US
Mailing Address - Phone:248-489-1573
Mailing Address - Fax:248-489-1586
Practice Address - Street 1:39303 COUNTRY CLUB DR
Practice Address - Street 2:A26
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-3478
Practice Address - Country:US
Practice Address - Phone:248-489-1573
Practice Address - Fax:248-489-1586
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302027476183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist