Provider Demographics
NPI:1871790642
Name:WINK, SCOTT ANTHONY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ANTHONY
Last Name:WINK
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 1:6975 E GHOST BAR ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83716-8834
Mailing Address - Country:US
Mailing Address - Phone:843-297-0585
Mailing Address - Fax:
Practice Address - Street 1:6975 E GHOST BAR ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83716-8834
Practice Address - Country:US
Practice Address - Phone:843-297-0585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10754183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist