Healthcare Provider Details

I. General information

NPI: 1538310289
Provider Name (Legal Business Name): JMS PHARMACY MANAGEMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2008
Last Update Date: 10/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 ROUTE 30 N
BOMOSEEN VT
05732-9647
US

IV. Provider business mailing address

275 ROUTE 30 N
BOMOSEEN VT
05732-9647
US

V. Phone/Fax

Practice location:
  • Phone: 802-468-5800
  • Fax: 802-468-5811
Mailing address:
  • Phone: 802-468-5800
  • Fax: 802-468-5811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number033.0002631
License Number StateVT

VIII. Authorized Official

Name: JASON SMITH
Title or Position: PRESIDENT
Credential:
Phone: 802-236-4154