Provider Demographics
NPI:1043437981
Name:ARCHER, SCOTT D (RPH)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:D
Last Name:ARCHER
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 1:28 PARK ST
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04841
Mailing Address - Country:US
Mailing Address - Phone:207-596-0036
Mailing Address - Fax:207-596-7943
Practice Address - Street 1:28 PARK ST.
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841
Practice Address - Country:US
Practice Address - Phone:207-596-0036
Practice Address - Fax:207-596-7943
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR3786183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist