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General NPI Number Information
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NPI Number | 1548740657
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Entity Type | Individual
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Provider Name | BENJAMIN D BAKER PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 08/17/2018
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 38 RUTLAND SHOPPING PLZ
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City | RUTLAND
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State | VT
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Zip | 05701-5201
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Country | US
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Telephone | 802-747-7887
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Fax |
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Provider Business Mailing Address
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Address Line | 179 MAIN ST
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City | PHELPS
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State | NY
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Zip | 14532-1056
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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 | 033.0134173
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License Number State | VT
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