Provider Demographics
NPI:1336446533
Name:SCAVO, LOUIS VINCENT (RPH)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:VINCENT
Last Name:SCAVO
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 1:138 OKATIE CENTER BLVD S
Mailing Address - Street 2:
Mailing Address - City:OKATIE
Mailing Address - State:SC
Mailing Address - Zip Code:29909-7546
Mailing Address - Country:US
Mailing Address - Phone:843-705-0999
Mailing Address - Fax:
Practice Address - Street 1:138 OKATIE CENTER BLVD S
Practice Address - Street 2:
Practice Address - City:OKATIE
Practice Address - State:SC
Practice Address - Zip Code:29909-7546
Practice Address - Country:US
Practice Address - Phone:843-705-0999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9636183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist