Provider Demographics
NPI:1780966580
Name:SKAROTE, KENNETH A
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:A
Last Name:SKAROTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5027 YOUNGSTOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:OH
Mailing Address - Zip Code:44446
Mailing Address - Country:US
Mailing Address - Phone:330-544-3462
Mailing Address - Fax:330-544-4292
Practice Address - Street 1:5027 YOUNGSTOWN WARREN RD
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-4905
Practice Address - Country:US
Practice Address - Phone:330-544-3462
Practice Address - Fax:330-544-4292
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-20850183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist