Provider Demographics
NPI:1952789083
Name:SCOTT, AGNES HALSTED
Entity type:Individual
Prefix:MS
First Name:AGNES
Middle Name:HALSTED
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AGNES
Other - Middle Name:ANN
Other - Last Name:HALSTED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:1100 TUNNEL RD
Mailing Address - Street 2:ATTN: PHARMACY
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-2576
Mailing Address - Country:US
Mailing Address - Phone:828-298-7911
Mailing Address - Fax:828-299-5980
Practice Address - Street 1:1100 TUNNEL RD
Practice Address - Street 2:ATTN: PHARMACY
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-2576
Practice Address - Country:US
Practice Address - Phone:828-298-7911
Practice Address - Fax:828-299-5980
Is Sole Proprietor?:No
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20046183500000X
TX30234183500000X
CA43555183500000X
NM00007905183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist