Provider Demographics
NPI:1851665251
Name:KIJOWSKI, SCOTT W (RPH)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:W
Last Name:KIJOWSKI
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 1:14210 SCOTTSLAWN RD
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43041-0001
Mailing Address - Country:US
Mailing Address - Phone:937-578-5800
Mailing Address - Fax:937-644-3795
Practice Address - Street 1:WORKSITE RX 14210 SCOTSLAWN RD
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43041
Practice Address - Country:US
Practice Address - Phone:937-578-5800
Practice Address - Fax:937-644-3795
Is Sole Proprietor?:No
Enumeration Date:2012-03-02
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03120808183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist