Provider Demographics
NPI:1164441036
Name:SCARBOROUGH FAMILY CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:SCARBOROUGH FAMILY CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RON
Authorized Official - Middle Name:RICHMOND
Authorized Official - Last Name:SCARBOROUGH
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:828-458-3242
Mailing Address - Street 1:5534 GULF DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-4000
Mailing Address - Country:US
Mailing Address - Phone:727-863-1407
Mailing Address - Fax:
Practice Address - Street 1:5534 GULF DR
Practice Address - Street 2:SUITE 3
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-4000
Practice Address - Country:US
Practice Address - Phone:727-863-1407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9849111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2323356Medicare PIN
NCV-06509Medicare UPIN