MR. SCOTT DAVIS WAGNER (NPI# 1841514593) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841514593 |
| Entity Type | Individual |
| Full Name | MR. SCOTT DAVIS WAGNER |
| Practice Address |
25059 State Route 11 Hallstead Plaza Hallstead PA 18822-8831 |
| Mailing Address |
125 Mulberry Dr Milford PA 18337-7261 |
| Practice Telephone | 5708792126 |
| Mailing Telephone | 5706878503 |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2010-03-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 053425-1 | NY | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | RP040460L | PA | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871113316 | Scott D Wagner I | Counselor | 319 E Tabor Ave Apt 15319, Fairfield, CA 94533-3955 | 2020-04-24 |
| 1932558822 | Scott Wagner | Pharmacist | 1018 Rosemont, Carmel, IN 46032-7709 | 2016-06-10 |
| 1124492350 | Scott Wagner | Speech-Language Pathologist | 5045 Kennelwood Dr, Saint Louis, MO 63129-2424 | 2015-11-27 |
| 1902909005 | Scott William Wagner | Dentist | 9035 East 62nd Street South, Tulsa, OK 74133 | 2006-09-06 |
| 1053340588 | Scott Brian Wagner | Chiropractor | 2109 India Rd, Charlottesville, VA 22901-2886 | 2006-06-30 |
| 1356801237 | Scott Forbes Wagner | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2019-03-25 |
| 1811279995 | Scott Wagner | Community Health Worker | 312 Crescent St, Greenville, CA 95947 | 2011-09-14 |
| 1861703613 | Scott Wagner | Orthopaedic Surgery | 8901 Wisconsin Ave, Bethesda, MD 20889-0001 | 2010-06-27 |
| 1538486162 | Scott Allen Wagner | Occupational Therapist | 210 S 12th St, Bismarck, ND 58504-5622 | 2010-04-21 |
| 1841499258 | Scott John Wagner | Registered Nurse | 3537 S I-35 E, Suite 305, Denton, TX 76210-6800 | 2007-07-16 |
| Street Address |
25059 STATE ROUTE 11 HALLSTEAD PLAZA |
| City | HALLSTEAD |
| State | PA |
| Zip Code | 18822-8831 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720573918 | Barnes-kasson County Hospital | Clinic/Center | 25059 State Route 11, Hallstead, PA 18822-8831 | 2018-06-29 |
| 1235456260 | Keith Donald Robinson | Pharmacist | 25059 State Route 11, Suite F, Hallstead, PA 18822-8831 | 2010-04-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558782060 | Neal Juraska | Pharmacist | 36 Rose St, Hallstead Family Pharmacy, Hallstead, PA 18822 | 2013-12-31 |
| 1942453311 | Heidi Ann Woodruff | Occupational Therapy Assistant | 616 Mountain Valley Rd, Hallstead, PA 18822 | 2008-10-29 |
| 1780749671 | Susan Marie Jackson | Family Medicine | 25066 Sr 11, Hallstead, PA 18822 | 2006-12-22 |
| 1598842023 | Reddon Drug Co. Inc. | Durable Medical Equipment & Medical Supplies | 25059 Sr 11, Hallstead, PA 18822 | 2006-11-01 |
| 1912523689 | Hallstead Family Pharmacy LLC | Pharmacy | 36 Rose St, Hallstead, PA 18822 | 2020-06-18 |
| 1346603016 | Donna C Holinej | Pharmacist | 25059 Sr 11, Po Box L, Hallstead, PA 18822 | 2016-03-31 |
| 1356615785 | Jody Lee Verdetto | Pharmacist | 25059 Sr 11, Hallstead, PA 18822 | 2012-03-02 |
| 1629101712 | Jeffrey Gonz | Technician/Technologist | 19 Main St, Hallstead, PA 18822 | 2007-03-14 |
| 1053409227 | Binghampton Optical Inc | Eyewear Supplier (Equipment, not the service) | 19 Main St, Hallstead, PA 18822 | 2006-10-11 |
| 1164528089 | Bernard Leo Remakus | Internal Medicine | Rr2 Steam Hollow Road, Hallstead, PA 18822-0367 | 2006-09-16 |
| Find all providers in zip 18822 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558782060 | Neal Juraska | Pharmacist | 36 Rose St, Hallstead Family Pharmacy, Hallstead, PA 18822 | 2013-12-31 |
| 1346603016 | Donna C Holinej | Pharmacist | 25059 Sr 11, Po Box L, Hallstead, PA 18822 | 2016-03-31 |
| 1356615785 | Jody Lee Verdetto | Pharmacist | 25059 Sr 11, Hallstead, PA 18822 | 2012-03-02 |
| 1235456260 | Keith Donald Robinson | Pharmacist | 25059 State Route 11, Suite F, Hallstead, PA 18822-8831 | 2010-04-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013704 | Truong Vu | Pharmacist | 1675 Christopher Columbus Blvd, Philadelphia, PA 19148-1402 | 2020-11-07 |
| 1376144212 | Gyuzel Gold | Pharmacist | 3668 Hancock Ln, Doylestown, PA 18902-6544 | 2020-11-06 |
| 1619578424 | Laurie A Fisher | Pharmacist | 325 W Freedom Ave, Burnham, PA 17009-1846 | 2020-11-06 |
| 1073114880 | Lawrence Roettenbacher | Pharmacist | 3560 Route 611 Ste 105, Bartonsville, PA 18321-9452 | 2020-11-06 |
| 1104427186 | Hannah Bae | Pharmacist | 315 N York Rd, Willow Grove, PA 19090-2621 | 2020-11-05 |
| 1285235283 | Luann Orehek Reno | Pharmacist | 567 Pa- 100 N, Bechtelsville, PA 19505 | 2020-11-05 |
| 1558962571 | Ashley Lynn Martire | Pharmacist | 3015 W Emaus Ave, Allentown, PA 18103-7107 | 2020-11-05 |
| 1184225237 | Scott Borkenhagen | Pharmacist | 3722 Nazareth Rd, Easton, PA 18045-8340 | 2020-11-05 |
| 1114528189 | Andrew Francis Christine | Pharmacist | 830 N Us Route 15, Dillsburg, PA 17019-1617 | 2020-11-05 |
| 1073114070 | Casey Joe Kulago | Pharmacist | 2121 S Atherton St, State College, PA 16801-7610 | 2020-11-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.