Provider Demographics
NPI:1669897559
Name:GULICK, ROSCOE SCOTT (RPH)
Entity type:Individual
Prefix:
First Name:ROSCOE
Middle Name:SCOTT
Last Name:GULICK
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 1:5010 AIRPORT PULLING RD N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-2407
Mailing Address - Country:US
Mailing Address - Phone:239-213-3359
Mailing Address - Fax:239-213-4212
Practice Address - Street 1:5010 AIRPORT PULLING RD N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-2407
Practice Address - Country:US
Practice Address - Phone:239-213-3359
Practice Address - Fax:239-213-4212
Is Sole Proprietor?:No
Enumeration Date:2014-02-28
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS48600183500000X
MO043425183500000X
KS1-11810183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist