Basic Information
Provider Information
NPI: 1003152513
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALLEN
FirstName: SCARLETT
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PHARM.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 803 INDUSTRIAL BLVD
Address2:  
City: SMYRNA
State: TN
PostalCode: 371676865
CountryCode: US
TelephoneNumber: 6157683018
FaxNumber: 6157683028
Practice Location
Address1: 803 INDUSTRIAL BLVD
Address2:  
City: SMYRNA
State: TN
PostalCode: 371676865
CountryCode: US
TelephoneNumber: 6157683018
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/02/2013
LastUpdateDate: 11/30/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/30/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X39472TNY Pharmacy Service ProvidersPharmacist 
183500000X68513CAN Pharmacy Service ProvidersPharmacist 
183500000X051299170ILN Pharmacy Service ProvidersPharmacist 

No ID Information.


Home