Provider Demographics
NPI:1891311692
Name:SCOTT, ANNA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:SCOTT
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 1:34535 HIDDEN PINE DR
Mailing Address - Street 2:
Mailing Address - City:FRASER
Mailing Address - State:MI
Mailing Address - Zip Code:48026-3515
Mailing Address - Country:US
Mailing Address - Phone:616-293-4535
Mailing Address - Fax:
Practice Address - Street 1:1815 ROCHESTER RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-4136
Practice Address - Country:US
Practice Address - Phone:248-546-6572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302042674183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist