Provider Demographics
NPI:1194320184
Name:FLINT, SCOTT W (RPH)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:W
Last Name:FLINT
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 1:527 HICKORY DR
Mailing Address - Street 2:
Mailing Address - City:MANAKIN SABOT
Mailing Address - State:VA
Mailing Address - Zip Code:23103-3209
Mailing Address - Country:US
Mailing Address - Phone:804-784-5531
Mailing Address - Fax:
Practice Address - Street 1:8820 W BROAD ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-5802
Practice Address - Country:US
Practice Address - Phone:804-747-5893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA020201813183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist