Provider Demographics
NPI:1528168796
Name:CROUSE, SCOTT A (RPH)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:A
Last Name:CROUSE
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 1:40476 306TH ST
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:SD
Mailing Address - Zip Code:57315-5826
Mailing Address - Country:US
Mailing Address - Phone:605-286-3011
Mailing Address - Fax:
Practice Address - Street 1:410 WEST 16TH AVENUE
Practice Address - Street 2:
Practice Address - City:TYNDALL
Practice Address - State:SD
Practice Address - Zip Code:57066
Practice Address - Country:US
Practice Address - Phone:605-589-4418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR55681835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy