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General NPI Number Information
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NPI Number | 1730014671
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Entity Type | Individual
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Provider Name | SCOTT MICHAEL KERSHAW PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 06/13/2026
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Last Update Date | 06/13/2026
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Provider Practice Location Address
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Address Line | 2400 UNSER BLVD SE
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City | RIO RANCHO
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State | NM
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Zip | 87124-3392
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Country | US
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Telephone | 505-253-7501
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Fax |
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Provider Business Mailing Address
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Address Line | 1829 TERRA DE SOL DR SE
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City | RIO RANCHO
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State | NM
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Zip | 87124-8864
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Country | US
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Telephone | 406-274-2931
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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 | PHA-PHA-LIC-7728
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP00009121
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License Number State | NM
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