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General NPI Number Information
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NPI Number | 1669696886
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Entity Type | Individual
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Provider Name | SCOTT QUINN BAISCH RPH
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Gender | Male
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 500 BURLINGTON ST SE
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City | MANDAN
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State | ND
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Zip | 58554-4281
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Country | US
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Telephone | 701-667-1843
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Fax | 701-667-4352
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Provider Business Mailing Address
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Address Line | 410 3RD AVE NW
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City | HAZEN
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State | ND
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Zip | 58545-4328
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Country | US
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Telephone | 701-748-2360
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Fax |
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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 | 3958
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License Number State | ND
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