Scott Clancey, PHARMD
Individual provider Active NPI Pharmacist · Wixom, MI
NPI 1699253229 · NPPES record last updated Aug 6, 2018
Key facts
- NPI
- 1699253229
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5302042757 (MI)
- Practice address
- 49900 Grand River Ave
Wixom, MI 48393-3308 - Phone
- (248) 449-8510
- Fax
- (248) 449-8565
- NPI assigned
- Aug 6, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302042757 | MI | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302042757 | MI | Yes |
Addresses
Primary practice location
49900 Grand River Ave
Wixom, MI 48393-3308
Mailing address
49900 Grand River Ave
Wixom, MI 48393-3308
Phone (248) 449-8510
Other providers in Wixom, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.