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General NPI Number Information
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NPI Number | 1326932849
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Entity Type | Individual
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Provider Name | ELIZABETH ROSE GAGNE PHARMD, RPH
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Gender | Female
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 321 MAIN ST
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City | WINOOSKI
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State | VT
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Zip | 05404-1380
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Country | US
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Telephone | 802-655-2444
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Fax |
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Provider Business Mailing Address
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Address Line | 70 OAK KNOLL RD
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City | WILLISTON
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State | VT
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Zip | 05495-9698
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Country | US
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Telephone | 802-598-4388
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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 | 033.0135691
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License Number State | VT
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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 | 33704
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License Number State | NC
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