Provider Demographics
NPI:1609867167
Name:J L SCOTT INC
Entity Type:Organization
Organization Name:J L SCOTT INC
Other - Org Name:SCOTT PHARMACEUTICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:C
Authorized Official - Last Name:MCLEOD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:334-792-2717
Mailing Address - Street 1:2021 ALEXANDER DR STE B
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-3003
Mailing Address - Country:US
Mailing Address - Phone:334-792-2717
Mailing Address - Fax:334-792-7917
Practice Address - Street 1:2021 ALEXANDER DR STE B
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-3003
Practice Address - Country:US
Practice Address - Phone:334-792-2717
Practice Address - Fax:334-792-7917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-03
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1087113336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL100039181Medicaid