Provider Demographics
NPI:1013284785
Name:NOSKER, SCOTT (RPH)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:
Last Name:NOSKER
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 1:6820 CENTENNIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-5114
Mailing Address - Country:US
Mailing Address - Phone:719-264-1665
Mailing Address - Fax:719-264-6772
Practice Address - Street 1:6820 CENTENNIAL BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-5114
Practice Address - Country:US
Practice Address - Phone:719-264-1665
Practice Address - Fax:719-264-6772
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16445183500000X
UT3083147183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist