Provider Demographics
NPI:1770039588
Name:PEARSON, SCOTT MICHAEL FLORINE (PHARMD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:MICHAEL FLORINE
Last Name:PEARSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8155 E FAIRMOUNT DR
Mailing Address - Street 2:APT. 128
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-6839
Mailing Address - Country:US
Mailing Address - Phone:651-210-6477
Mailing Address - Fax:
Practice Address - Street 1:12505 E. 16TH AVE
Practice Address - Street 2:MAIL STOP F757
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045
Practice Address - Country:US
Practice Address - Phone:720-848-5339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA0021303183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist