Provider Demographics
NPI:1518144377
Name:GROEHLER, SCOTT (RPH)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:GROEHLER
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 1:421 N HOLCOMBE AVE
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55355-2224
Mailing Address - Country:US
Mailing Address - Phone:320-593-1752
Mailing Address - Fax:
Practice Address - Street 1:125 MAIN ST N
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-1807
Practice Address - Country:US
Practice Address - Phone:320-587-4941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN114285183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist