# SCOTT PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174094478
- **Authorized official:** DR. DAVID JEFFREY SCOTT PHARMD (CO-OWNER/PHARMACIST)
- **Authorized official phone:** (563) 425-4530

## Contact information

- **Practice address:** 238 S MAIN ST, FAYETTE, IA 52142-9301
- **Practice address phone:** (563) 425-4530
- **Practice address fax:** (563) 425-3261
- **Mailing address:** PO BOX 188, FAYETTE, IA 52142-0188
- **Mailing address phone:** (563) 425-4530
- **Mailing address fax:** (563) 425-3261

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 12/12/2018
- **Last updated:** 12/12/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0479857 | — | IA |