Provider Demographics
NPI:1528343324
Name:BELL, SCOTT A (RPH)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:A
Last Name:BELL
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 1:3490 STOCKTON HILL RD
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86409-3680
Mailing Address - Country:US
Mailing Address - Phone:928-757-3338
Mailing Address - Fax:928-757-8472
Practice Address - Street 1:3490 STOCKTON HILL RD
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86409-3680
Practice Address - Country:US
Practice Address - Phone:928-757-3338
Practice Address - Fax:928-757-8472
Is Sole Proprietor?:No
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS018797183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZS018797OtherNPI FOR VACCINATIONS