Healthcare Provider Details

I. General information

NPI: 1154380178
Provider Name (Legal Business Name): PHARMACY HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 09/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 MAPLE ST SUITE 21
MIDDLEBURY VT
05753-1595
US

IV. Provider business mailing address

99 MAPLE ST SUITE 21
MIDDLEBURY VT
05753-1595
US

V. Phone/Fax

Practice location:
  • Phone: 802-388-9801
  • Fax: 802-388-4146
Mailing address:
  • Phone: 802-388-9801
  • Fax: 802-388-4146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number332BX2000X
License Number StateVT

VIII. Authorized Official

Name: MRS. MARIA M BURNS
Title or Position: PHS PRESIDENT
Credential:
Phone: 802-458-3110