Provider Demographics
NPI:1932585437
Name:PARRISH, SCOTT (PHARMD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:PARRISH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 E BONITA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-3186
Mailing Address - Country:US
Mailing Address - Phone:909-599-8874
Mailing Address - Fax:
Practice Address - Street 1:220 E BONITA AVE
Practice Address - Street 2:
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-3186
Practice Address - Country:US
Practice Address - Phone:909-599-8874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-06
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48865183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist