Provider Demographics
NPI:1871328799
Name:EPPLEY, SCOTT (PHARMD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:EPPLEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 SOUTH AVENUE
Mailing Address - Street 2:DEPARTMENT OF PHARMACY, MAILSTOP LML-001
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601
Mailing Address - Country:US
Mailing Address - Phone:608-775-9492
Mailing Address - Fax:
Practice Address - Street 1:1900 SOUTH AVENUE
Practice Address - Street 2:DEPARTMENT OF PHARMACY, MAILSTOP LML-001
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601
Practice Address - Country:US
Practice Address - Phone:608-775-9492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15529-40183500000X, 1835P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0200XPharmacy Service ProvidersPharmacistPediatrics
No183500000XPharmacy Service ProvidersPharmacist