Scott Bolesta
Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Forty Fort, PA
NPI 1669981403 · NPPES record last updated Sep 25, 2017
Key facts
- NPI
- 1669981403
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
- License
- RP045571L (PA)
- Practice address
- 190 Welles St Ste 128
Forty Fort, PA 18704-4961 - Phone
- (570) 714-6643
- NPI assigned
- Sep 25, 2017
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP045571L | PA | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | RP045571L | PA | Yes |
Addresses
Primary practice location
190 Welles St Ste 128
Forty Fort, PA 18704-4961
Mailing address
105 Wakefield Rd
Shavertown, PA 18708-9312
Other providers in Forty Fort, PA
- Berwick Home Care Services LLC
- Beyond Behavior Consulting
- Beyond Behavior Consulting
- Beyond Grateful
- Ashley Ellen Bodisch
- William H. Boyle
- Larry A. Brand
- Taylor Lynn Budwash
- Terri Bugelholl
- Candice J Bukevicz
All providers in Forty Fort, PA · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2017. 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.