Provider Demographics
NPI:1932466497
Name:WOODRUFF, SCOTT D (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:D
Last Name:WOODRUFF
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 NW OLD TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64151-1945
Mailing Address - Country:US
Mailing Address - Phone:816-365-4394
Mailing Address - Fax:
Practice Address - Street 1:5001 NW OLD TRAIL RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64151-1945
Practice Address - Country:US
Practice Address - Phone:816-365-4394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-20
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO044666183500000X
IA15669183500000X
KS1-13449183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist