Provider Demographics
NPI:1881810620
Name:CASTOR, SCOTT C (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:C
Last Name:CASTOR
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 1:416 CRAGMONT ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:IN
Mailing Address - Zip Code:47250-3002
Mailing Address - Country:US
Mailing Address - Phone:812-273-5384
Mailing Address - Fax:
Practice Address - Street 1:1 KINGS DAUGHTERS DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:IN
Practice Address - Zip Code:47250-3300
Practice Address - Country:US
Practice Address - Phone:812-265-0182
Practice Address - Fax:812-265-0504
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26019303A1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy