Provider Demographics
NPI:1164705331
Name:ROSPOND, SCOTT L (BS PHARMACY)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:L
Last Name:ROSPOND
Suffix:
Gender:M
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12753 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-8246
Mailing Address - Country:US
Mailing Address - Phone:515-226-1786
Mailing Address - Fax:
Practice Address - Street 1:12753 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8246
Practice Address - Country:US
Practice Address - Phone:515-226-1786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA18870183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist