Donnie Joe Scrivner, RPH

Individual provider Active NPI Pharmacist · Collinsville, MS

NPI 1902154164 · NPPES record last updated Aug 20, 2012

Key facts

NPI
1902154164
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
E6580 (MS)
Practice address
9155 Highway 19 N
Collinsville, MS 39325-9330
Phone
(601) 626-8338
Fax
(601) 626-8082
NPI assigned
Aug 20, 2012
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
E6580MSMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X E6580 MS Yes

Addresses

Primary practice location

9155 Highway 19 N
Collinsville, MS 39325-9330

Mailing address

9155 Highway 19 N
Collinsville, MS 39325-9330
Phone (601) 626-8338

Other providers in Collinsville, MS

All providers in Collinsville, MS · Pharmacist in Mississippi

Sources for this page

Verify at the official NPI Registry.