Provider Demographics
NPI:1841319076
Name:SCOTT, HEATHER DIANE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:DIANE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 HADDEN HALL CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23838-5120
Mailing Address - Country:US
Mailing Address - Phone:804-651-6132
Mailing Address - Fax:804-733-8819
Practice Address - Street 1:1950 S SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-2729
Practice Address - Country:US
Practice Address - Phone:804-733-7711
Practice Address - Fax:804-733-8819
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202206262183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0202206262OtherVA PHARMACY LICENSE #