Provider Demographics
NPI:1760622013
Name:SCOTT'S RX INC
Entity Type:Organization
Organization Name:SCOTT'S RX INC
Other - Org Name:SCOTT'S RX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/PHCY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-733-4100
Mailing Address - Street 1:2215 N HERCULES AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33763-2325
Mailing Address - Country:US
Mailing Address - Phone:727-733-4100
Mailing Address - Fax:727-733-8426
Practice Address - Street 1:2215 N HERCULES AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33763-2325
Practice Address - Country:US
Practice Address - Phone:727-733-4100
Practice Address - Fax:727-733-8426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-26
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X, 3336L0003X
FLPH239123336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2119198OtherPK
FL001153000Medicaid
FL001153001Medicaid
6372650001Medicare NSC