Healthcare Provider Details

I. General information

NPI: 1033940168
Provider Name (Legal Business Name): BRENT CHATOFF PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2024
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 EXECUTIVE DR
SHELBURNE VT
05482-7142
US

IV. Provider business mailing address

62 ADAMS SCHOOL RD
GRAND ISLE VT
05458-2106
US

V. Phone/Fax

Practice location:
  • Phone: 802-985-0008
  • Fax: 802-985-0011
Mailing address:
  • Phone: 802-598-2204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number003.0135427
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: