Healthcare Provider Details

I. General information

NPI: 1770413965
Provider Name (Legal Business Name): JULIE EVA MACDOUGALL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COLCHESTER AVE
BURLINGTON VT
05401-1473
US

IV. Provider business mailing address

12 PETERSON TER
SOUTH BURLINGTON VT
05403-6455
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-3360
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number033.0103438
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: