MEDICARE: MR. SCOTT H BURGARD R.PH.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	16969	NV
2	183500000X	Pharmacist	63399	CA

General Provider Information

NPI Number	:	1154769511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SCOTT H BURGARD R.PH.

Provider Business Mailing Address
First Line	:	8001 LINCOLN AVE
Second Line	:	SUITE 800
City	:	SKOKIE
State	:	IL
Zip	:	60077-3695
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3550 S RAINBOW BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-1004
Country	:	US
Telephone Number	:	702-252-4600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2013
Last Update Date	:	08/06/2013

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Directions to “ MR. SCOTT H BURGARD R.PH.” Practice Location

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