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1619197274 NPI number — SCOTT S COURSEN RPH

NPI Number: 1619197274
Health Care Provider/Practitioner: SCOTT S COURSEN RPH

Information about “1619197274” NPI (SCOTT S COURSEN RPH) exists in 1619197274 in HTML format HTML  |  1619197274 in plain Text format TXT  |  1619197274 in PDF (Portable Document Format) PDF  |  1619197274 in an XML format XML  formats.

NPI Number : 1619197274 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1619197274",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "COURSEN",
    "FirstName": "SCOTT",
    "MiddleName": "S",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "RPH",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5511 DIBBLE RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "KINGSVILLE",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "44048-9807",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "440-224-3393",
    "MailingAddressFaxNumber": "440-992-1513",
    "FirstLinePracticeLocationAddress": "3315 N RIDGE RD E STE 100",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ASHTABULA",
    "PracticeLocationAddressStateName": "OH",
    "PracticeLocationAddressPostalCode": "44004-4347",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "440-992-7477",
    "PracticeLocationAddressFaxNumber": "440-992-1513",
    "EnumerationDate": "04/26/2007",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "183500000X",
          "TaxonomyName": "Pharmacist",
          "LicenseNumber": "03-3-16988",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "183500000X",
          "TaxonomyName": "Pharmacist",
          "LicenseNumber": "PR4399",
          "LicenseNumberStateCode": "ME",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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