Provider Demographics
NPI:1073601860
Name:SCARBROUGH MEDICAL ARTS PHARMACY INC
Entity Type:Organization
Organization Name:SCARBROUGH MEDICAL ARTS PHARMACY INC
Other - Org Name:SCARBROUGH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RESPONSIBLE PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:419-423-1513
Mailing Address - Street 1:1809 SOUTH MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1809 SOUTH MAIN ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840
Practice Address - Country:US
Practice Address - Phone:419-423-1513
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0004XSuppliersPharmacyCompounding PharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0509748Medicaid