Provider Demographics
NPI:1528173929
Name:SCARBROUGH, DEAN CARROLL (RPH)
Entity type:Individual
Prefix:
First Name:DEAN
Middle Name:CARROLL
Last Name:SCARBROUGH
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 1:505 S BUTTERNUT ST
Mailing Address - Street 2:
Mailing Address - City:DESHLER
Mailing Address - State:OH
Mailing Address - Zip Code:43516-1339
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:139 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DESHLER
Practice Address - State:OH
Practice Address - Zip Code:43516-1159
Practice Address - Country:US
Practice Address - Phone:419-278-1851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-104441835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy