Healthcare Provider Details

I. General information

NPI: 1902932171
Provider Name (Legal Business Name): JOSEPH SCOTT MISKOVSKY RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2007
Last Update Date: 10/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 MAIN ST
FOREST CITY PA
18421-1420
US

IV. Provider business mailing address

420 MAIN ST
FOREST CITY PA
18421-1420
US

V. Phone/Fax

Practice location:
  • Phone: 570-785-5400
  • Fax: 570-785-3675
Mailing address:
  • Phone: 570-785-5400
  • Fax: 570-785-3675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP032437L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: