Healthcare Provider Details

I. General information

NPI: 1578685970
Provider Name (Legal Business Name): MICHAEL JOSEPH LAUBACH R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 09/28/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 RUTLAND SHOPPING PLAZA
RUTLAND VT
05701
US

IV. Provider business mailing address

1023 BOARDMAN HILL RD
WEST RUTLAND VT
05777-9551
US

V. Phone/Fax

Practice location:
  • Phone: 802-747-7880
  • Fax:
Mailing address:
  • Phone: 315-601-8973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number053308
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH233021
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberR2221
License Number StateNH
# 4
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0033.0076667
License Number StateVT
# 5
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number32178
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: