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General NPI Number Information
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NPI Number | 1336453489
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Entity Type | Individual
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Provider Name | GERALDINE BENNETT
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Gender | Female
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Dates
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Enumeration Date | 07/31/2010
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Last Update Date | 07/31/2010
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Provider Practice Location Address
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Address Line | 288 UNION AVE
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City | LACONIA
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State | NH
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Zip | 03246-3115
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Country | US
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Telephone | 603-528-1700
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 377
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City | MOULTONBOROUGH
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State | NH
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Zip | 03254-0377
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Country | US
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Telephone |
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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 | 3424
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License Number State | NH
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