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General NPI Number Information
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NPI Number | 1245514728
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Entity Type | Individual
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Provider Name | MICHELE OBRIEN RPH
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Gender | Female
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Dates
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Enumeration Date | 10/03/2011
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Last Update Date | 10/03/2011
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Provider Practice Location Address
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Address Line | 10 WOODSTOCK AVE
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City | RUTLAND
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State | VT
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Zip | 05701-3514
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Country | US
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Telephone | 802-773-6980
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 174
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City | HAMPTON
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State | NY
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Zip | 12837-0174
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Country | US
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Telephone | 518-282-9721
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 039655
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0330003768
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License Number State | VT
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