Provider Demographics
NPI:1053692681
Name:SCOTT, DEBORAH MUNGAN (RPH)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:MUNGAN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:ANNE
Other - Last Name:MUNGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:7804 CINCINNATI DAYTON RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-6003
Mailing Address - Country:US
Mailing Address - Phone:513-779-8302
Mailing Address - Fax:
Practice Address - Street 1:7804 CINCINNATI DAYTON RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-6003
Practice Address - Country:US
Practice Address - Phone:513-779-8302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03119217183500000X
IN26016979A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist