Scott Borntreger, RPH
Individual provider Active NPI Pharmacist · Auburn, IL
NPI 1003418971 · NPPES record last updated Nov 14, 2020
Key facts
- NPI
- 1003418971
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051036639 (IL)
- Practice address
- 620 E Jackson St
Auburn, IL 62615-9784 - Phone
- (217) 438-6141
- Fax
- (217) 438-3447
- NPI assigned
- Nov 14, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051036639 | IL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051036639 | IL | Yes |
Addresses
Primary practice location
620 E Jackson St
Auburn, IL 62615-9784
Mailing address
620 E Jackson St
Auburn, IL 62615-9784
Phone (217) 438-6141
Other practice location 1
1401 N 8th St
Vandalia, IL 62471-1028
Phone (618) 283-0196
Other providers in Auburn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.