Provider Demographics
NPI:1447929278
Name:MCGOWAN, SCOTT (RPH)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:
Last Name:MCGOWAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:LEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:19533-8870
Mailing Address - Country:US
Mailing Address - Phone:888-441-0001
Mailing Address - Fax:610-926-9730
Practice Address - Street 1:7 CHERRY ST
Practice Address - Street 2:
Practice Address - City:LEESPORT
Practice Address - State:PA
Practice Address - Zip Code:19533-8870
Practice Address - Country:US
Practice Address - Phone:888-441-0001
Practice Address - Fax:610-926-9730
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP045086L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist