Provider Demographics
NPI:1487982641
Name:SCS NUTRITION CONSULTING, LLC
Entity type:Organization
Organization Name:SCS NUTRITION CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD
Authorized Official - Phone:256-533-1507
Mailing Address - Street 1:532 MADISON ST SE
Mailing Address - Street 2:C/O PEAK CLINIC FOR FAMILY MEDICINE
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4205
Mailing Address - Country:US
Mailing Address - Phone:256-508-0214
Mailing Address - Fax:
Practice Address - Street 1:532 MADISON ST SE
Practice Address - Street 2:C/O PEAK CLINIC FOR FAMILY MEDICINE
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4205
Practice Address - Country:US
Practice Address - Phone:256-508-0214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-30
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1095133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051555027Medicare PIN