Healthcare Provider Details

I. General information

NPI: 1972826162
Provider Name (Legal Business Name): DAVID W VOGHT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2010
Last Update Date: 03/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 CHURCH ST
CANAJOHARIE NY
13317-1165
US

IV. Provider business mailing address

26 CHURCH ST
CANAJOHARIE NY
13317-1165
US

V. Phone/Fax

Practice location:
  • Phone: 518-673-8086
  • Fax: 518-673-5112
Mailing address:
  • Phone: 518-673-8086
  • Fax: 518-673-5112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number34315
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: