Provider Demographics
NPI:1609045061
Name:SCARBROUGH, NANCY (RPH)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:SCARBROUGH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6050 PEACHTREE PKWY
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-3336
Mailing Address - Country:US
Mailing Address - Phone:770-242-3346
Mailing Address - Fax:770-242-3347
Practice Address - Street 1:6050 PEACHTREE PKWY
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-3336
Practice Address - Country:US
Practice Address - Phone:770-242-3346
Practice Address - Fax:770-242-3347
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA14709183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist