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General NPI Number Information
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NPI Number | 1487961629
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Entity Type | Individual
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Provider Name | CARL PETER EISENBIEGLER PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 09/09/2010
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Last Update Date | 09/09/2010
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Provider Practice Location Address
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Address Line | 407 BROAD ST KINNEY DRUGS #94
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City | LYNDONVILLE
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State | VT
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Zip | 05851-5600
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Country | US
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Telephone | 802-626-3779
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Fax | 802-626-1089
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Provider Business Mailing Address
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Address Line | 220 PAUS LN
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City | HYDE PARK
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State | VT
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Zip | 05655-4428
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Country | US
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Telephone | 978-590-1923
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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 | 0003794
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License Number State | VT
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