Provider Demographics
NPI:1356633887
Name:REHRIG, SCOTT B (RPH)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:B
Last Name:REHRIG
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 1:2411 COLUMBIA BLVD
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-3135
Mailing Address - Country:US
Mailing Address - Phone:570-387-1901
Mailing Address - Fax:
Practice Address - Street 1:2411 COLUMBIA BLVD
Practice Address - Street 2:
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-3135
Practice Address - Country:US
Practice Address - Phone:570-387-1901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP037635L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist