Healthcare Provider Details

I. General information

NPI: 1649186800
Provider Name (Legal Business Name): SCOTT MASS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 LOWER MOUNTAIN VIEW DR
COLCHESTER VT
05446-5830
US

IV. Provider business mailing address

11 FRANKLIN ST UNIT 107
ESSEX JUNCTION VT
05452-4527
US

V. Phone/Fax

Practice location:
  • Phone: 802-654-3156
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number033.0136144
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: