Provider Demographics
NPI:1942813399
Name:JOHNSON, SCOTTE M (PHARMD,RPH)
Entity Type:Individual
Prefix:DR
First Name:SCOTTE
Middle Name:M
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PHARMD,RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 FREDERICK BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-3314
Mailing Address - Country:US
Mailing Address - Phone:757-391-9123
Mailing Address - Fax:
Practice Address - Street 1:6 TREEBARK PL
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2179
Practice Address - Country:US
Practice Address - Phone:757-602-4458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202212514183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist