Scott W Vankuren, RPH
Individual provider Active NPI Pharmacist · Middleburgh, NY
NPI 1164566501 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1164566501
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 037836 (NY)
- Practice address
- 4448 State Route 30
Middleburgh, NY 12122-5706 - Phone
- (518) 827-4488
- Fax
- (518) 827-4477
- NPI assigned
- Feb 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|
| 037836 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Schoharie Valley Pharmacy Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 037836 | NY | Yes |
Addresses
Primary practice location
4448 State Route 30
Middleburgh, NY 12122-5706
Mailing address
PO Box 937
Middleburgh, NY 12122-0937
Phone (518) 827-6602
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 037836 | Other | NY | STATE LIC |
Other providers in Middleburgh, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.