Provider Demographics
NPI:1538320098
Name:SCHOLL, JUSTIN DOUGLAS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:DOUGLAS
Last Name:SCHOLL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1858 WEST GRANDVIEW BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16507-1609
Mailing Address - Country:US
Mailing Address - Phone:814-866-8430
Mailing Address - Fax:
Practice Address - Street 1:1858 WEST GRANDVIEW BOULEVARD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1609
Practice Address - Country:US
Practice Address - Phone:814-866-8430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441940183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist