Provider Demographics
NPI:1174600605
Name:RICHEY, SCOT DOUGLAS (RPH)
Entity type:Individual
Prefix:
First Name:SCOT
Middle Name:DOUGLAS
Last Name:RICHEY
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 1:15735 N AMITY ST
Mailing Address - Street 2:
Mailing Address - City:PLATTE CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64079-8102
Mailing Address - Country:US
Mailing Address - Phone:816-532-1093
Mailing Address - Fax:
Practice Address - Street 1:15735 N AMITY ST
Practice Address - Street 2:
Practice Address - City:PLATTE CITY
Practice Address - State:MO
Practice Address - Zip Code:64079-8102
Practice Address - Country:US
Practice Address - Phone:816-532-1093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-12251183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist