Healthcare Provider Details

I. General information

NPI: 1184896979
Provider Name (Legal Business Name): LEWIS ALEXANDER SCOTT JR. RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2008
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10862 COPP HILL RD
CORNING NY
14830-3757
US

IV. Provider business mailing address

76 VETERANS AVE HOSPITAL BUILDING
BATH NY
14810-0810
US

V. Phone/Fax

Practice location:
  • Phone: 607-936-4850
  • Fax:
Mailing address:
  • Phone: 607-664-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number037822
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: