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General NPI Number Information
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NPI Number | 1487949293
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Entity Type | Individual
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Provider Name | RAINA E GUPTON PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/09/2011
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Last Update Date | 06/09/2011
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Provider Practice Location Address
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Address Line | 896 PUTNEY RD SUITE 6
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City | BRATTLEBORO
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State | VT
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Zip | 05301-7169
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Country | US
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Telephone | 802-257-1051
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Fax |
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Provider Business Mailing Address
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Address Line | 907 VERMONT ROUTE 30
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City | NEWFANE
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State | VT
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Zip | 05345-9655
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Country | US
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Telephone | 802-365-9885
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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 | 033.0003621
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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 | RPH020130
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License Number State | GA
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