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General NPI Number Information
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NPI Number | 1306441407
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Entity Type | Individual
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Provider Name | SCOTT ARNOLD WILSON
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Gender | Male
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Dates
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Enumeration Date | 12/04/2020
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Last Update Date | 12/04/2020
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Provider Practice Location Address
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Address Line | US HIGHWAY 40 EAST
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City | RICHEYVILLE
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State | PA
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Zip | 15358-0496
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Country | US
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Telephone | 724-632-6555
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Fax | 724-632-5436
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Provider Business Mailing Address
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Address Line | PO BOX 496
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City | RICHEYVILLE
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State | PA
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Zip | 15358-0496
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Country | US
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Telephone | 724-632-6555
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Fax | 724-632-5436
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP034526R
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License Number State | PA
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