Provider Demographics
NPI:1942930854
Name:FONTENOT SCOTT PHARMACY
Entity Type:Organization
Organization Name:FONTENOT SCOTT PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:FORREST
Authorized Official - Middle Name:
Authorized Official - Last Name:FONTENOT
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:337-235-5216
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:SCOTT
Mailing Address - State:LA
Mailing Address - Zip Code:70583-0188
Mailing Address - Country:US
Mailing Address - Phone:337-235-5216
Mailing Address - Fax:337-235-5217
Practice Address - Street 1:1000 SAINT MARY ST
Practice Address - Street 2:
Practice Address - City:SCOTT
Practice Address - State:LA
Practice Address - Zip Code:70583
Practice Address - Country:US
Practice Address - Phone:337-235-5216
Practice Address - Fax:337-235-5217
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FONTENOT SCOTT PHARMACY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy