Provider Demographics
NPI:1962835629
Name:ASHBY, MIKEL SCOTT (RPH)
Entity Type:Individual
Prefix:MR
First Name:MIKEL
Middle Name:SCOTT
Last Name:ASHBY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 ELKS POINT RD
Mailing Address - Street 2:PO BOX 11111
Mailing Address - City:ZEPHYR COVE
Mailing Address - State:NV
Mailing Address - Zip Code:89448-8001
Mailing Address - Country:US
Mailing Address - Phone:775-586-1088
Mailing Address - Fax:775-586-9019
Practice Address - Street 1:212 ELKS POINT RD
Practice Address - Street 2:
Practice Address - City:ZEPHYR COVE
Practice Address - State:NV
Practice Address - Zip Code:89448-8001
Practice Address - Country:US
Practice Address - Phone:775-586-1088
Practice Address - Fax:775-586-9019
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14672183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT154036-1701OtherUTAH STATE BOARD OF PHARMACY
NV14673OtherNEVADA STATE BOARD OF PHARMACY