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General NPI Number Information
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NPI Number | 1124166624
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Entity Type | Organization
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Legal Business Name | JO-MAR INC.
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 07/30/2008
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Provider Practice Location Address
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Address Line | 921 US RT 302
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City | BARRE
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State | VT
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Zip | 05641-4465
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Country | US
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Telephone | 802-479-2521
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Fax | 802-476-2091
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Provider Business Mailing Address
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Address Line | 921 US RT 302
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City | BARRE
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State | VT
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Zip | 05641-4465
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Country | US
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Telephone | 802-479-2521
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Fax | 802-476-2091
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Authorized Official
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Title or Position | PRESIDENT JO-MAR INC
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Name | MR. JOHN J. MARCHELEWICZ
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Credential | RPH
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Telephone | 802-479-2521
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 0380001252
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License Number State | VT
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