Provider Demographics
NPI:1851437487
Name:SCOTT FAMILY PHARMACY LLC
Entity Type:Organization
Organization Name:SCOTT FAMILY PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:573-246-2514
Mailing Address - Street 1:PO BOX 127
Mailing Address - Street 2:414 WEST GRAND AVE
Mailing Address - City:CAMPBELL
Mailing Address - State:MO
Mailing Address - Zip Code:63933-0127
Mailing Address - Country:US
Mailing Address - Phone:573-246-2514
Mailing Address - Fax:573-246-2474
Practice Address - Street 1:414 W GRAND AVE
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:MO
Practice Address - Zip Code:63933-1524
Practice Address - Country:US
Practice Address - Phone:573-246-2514
Practice Address - Fax:573-246-2474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002014845332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies