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General NPI Number Information
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NPI Number | 1417390295
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Entity Type | Organization
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Legal Business Name | PORTER HOSPITAL, INC.
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Dates
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Enumeration Date | 04/11/2013
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Last Update Date | 05/09/2013
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Provider Practice Location Address
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Address Line | 115 PORTER DR
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City | MIDDLEBURY
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State | VT
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Zip | 05753-8423
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Country | US
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Telephone | 802-388-8896
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Fax | 802-388-4709
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Provider Business Mailing Address
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Address Line | 115 PORTER DR
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City | MIDDLEBURY
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State | VT
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Zip | 05753-8423
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Country | US
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Telephone | 802-388-8896
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Fax | 802-388-4709
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Authorized Official
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Title or Position | PHARMACY DIRECTOR
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Name | RENEE MOSIER
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Credential |
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Telephone | 802-388-5624
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 141.0093571
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License Number State | VT
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