Provider Demographics
NPI:1902932171
Name:MISKOVSKY, JOSEPH SCOTT (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:SCOTT
Last Name:MISKOVSKY
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 1:420 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:PA
Mailing Address - Zip Code:18421-1420
Mailing Address - Country:US
Mailing Address - Phone:570-785-5400
Mailing Address - Fax:570-785-3675
Practice Address - Street 1:420 MAIN ST
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:PA
Practice Address - Zip Code:18421-1420
Practice Address - Country:US
Practice Address - Phone:570-785-5400
Practice Address - Fax:570-785-3675
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP032437L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP032437LOtherPHARMACY LICENSE #