Healthcare Provider Details
I. General information
NPI: 1225031800
Provider Name (Legal Business Name): HOTEL PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/27/2005
Last Update Date: 02/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20 ELLIOT ST NO 1
BRATTLEBORO VT
05301-3216
US
IV. Provider business mailing address
20 ELLIOT ST NO 1
BRATTLEBORO VT
05301-3216
US
V. Phone/Fax
- Phone: 802-254-2303
- Fax: 802-257-0023
- Phone: 802-254-2303
- Fax: 802-257-0023
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 0380000565 |
| License Number State | VT |
VIII. Authorized Official
Name:
MARY
GIAMARTINO
Title or Position: OWNER AND PRESIDENT
Credential: RPH
Phone: 802-254-2303