Provider Demographics
NPI:1386998540
Name:LAMB, SCOTT (RPH)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:LAMB
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 1:3000 N MARKET ST
Mailing Address - Street 2:BROOKSHIRE'S PHARMACY
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71107-4062
Mailing Address - Country:US
Mailing Address - Phone:318-424-3251
Mailing Address - Fax:318-424-0326
Practice Address - Street 1:3000 N MARKET ST
Practice Address - Street 2:BROOKSHIRE'S PHARMACY
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71107-4062
Practice Address - Country:US
Practice Address - Phone:318-424-3251
Practice Address - Fax:318-424-0326
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16256183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist