Scott L Courtney, RPH
Individual provider Active NPI Pharmacist · Waterloo, IL
NPI 1497782601 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1497782601
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- Practice address
- 3656 Lower Saxtown Rd
Waterloo, IL 62298-4604 - Phone
- (618) 476-3370
- Fax
- (617) 345-0545
- NPI assigned
- Jun 26, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|
| 051030804 | IL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | IL | Yes |
Addresses
Primary practice location
3656 Lower Saxtown Rd
Waterloo, IL 62298-4604
Mailing address
3656 Lower Saxtown Rd
Waterloo, IL 62298-4604
Phone (618) 476-3370
Other providers in Waterloo, IL
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.