Healthcare Provider Details

I. General information

NPI: 1194500470
Provider Name (Legal Business Name): ALI KHANAFER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2023
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

476 CANAL ST
BRATTLEBORO VT
05301-6621
US

IV. Provider business mailing address

476 CANAL ST
BRATTLEBORO VT
05301-6621
US

V. Phone/Fax

Practice location:
  • Phone: 802-264-4366
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number033.0135866
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: