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NPI Code Detail

MEDICARE: SCOTT LISZEWSKI

MEDICARE: SCOTT LISZEWSKI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist0024267CO

General Provider Information

NPI Number : 1740994904
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTT LISZEWSKI
Provider Business Mailing Address
First Line : 2458 1/2 BROOKWILLOW LOOP
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81505-4801
Country : US
Telephone Number : 719-213-3568
Fax Number :
Provider Business Practice Location Address
First Line : 2512 BROADWAY
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81507-2758
Country : US
Telephone Number : 303-744-8660
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2023
Last Update Date : 01/11/2023

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Directions to “ SCOTT LISZEWSKI ” Practice Location

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