Provider Demographics
NPI:1770952749
Name:SCRUGGS, MICHAEL EDDIE II (PHARMD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:EDDIE
Last Name:SCRUGGS
Suffix:II
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 S BROADWAY UNIT 180
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2519
Mailing Address - Country:US
Mailing Address - Phone:864-680-0299
Mailing Address - Fax:
Practice Address - Street 1:3401 S BROADWAY UNIT 180
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2519
Practice Address - Country:US
Practice Address - Phone:864-680-0299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36051183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist