Provider Demographics
NPI:1750673174
Name:BUCKMAN-SCARBOROUGH, ANGELA RAE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:RAE
Last Name:BUCKMAN-SCARBOROUGH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 CENTURY CENTER PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134-8822
Mailing Address - Country:US
Mailing Address - Phone:901-385-3600
Mailing Address - Fax:
Practice Address - Street 1:1640 CENTURY CENTER PKWY
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38134-8822
Practice Address - Country:US
Practice Address - Phone:901-385-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33828183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist