MEDICARE: MONTPELIER PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	0380066846	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2126035	OTHER		PK

General Provider Information

NPI Number	:	1235443441
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTPELIER PHARMACY INC

Provider Business Mailing Address
First Line	:	413 CANAL ST
Second Line	:
City	:	BRATTLEBORO
State	:	VT
Zip	:	05301-6619
Country	:	US
Telephone Number	:	802-254-7777
Fax Number	:	802-254-8444

Provider Business Practice Location Address
First Line	:	413 CANAL ST
Second Line	:
City	:	BRATTLEBORO
State	:	VT
Zip	:	05301-6619
Country	:	US
Telephone Number	:	802-254-7777
Fax Number	:	802-254-8444

Authorized Official
Title or Position	:	PHARMACIST MANAGER
Name	:	ANDREW MILLER
Credential	:
Telephone Number	:	802-254-7777

Provider Enumeration Date	:	07/29/2010
Last Update Date	:	01/20/2017

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Directions to “MONTPELIER PHARMACY INC ” Practice Location

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