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General NPI Number Information
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NPI Number | 1558039644
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Entity Type | Organization
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Legal Business Name | MAXWELLS PHARMACY INC
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Dates
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Enumeration Date | 09/02/2021
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 242 PEARL ST
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City | BURLINGTON
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State | VT
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Zip | 05401-8532
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Country | US
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Telephone | 802-862-1491
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Fax | 802-865-2208
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Provider Business Mailing Address
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Address Line | 242 PEARL ST
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City | BURLINGTON
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State | VT
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Zip | 05401-8532
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Country | US
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Telephone | 802-862-1491
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Fax | 802-865-2208
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Authorized Official
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Title or Position | PRESIDENT/ TREAS.
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Name | KYLE MAXWELL
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Credential |
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Telephone | 802-862-1562
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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 |
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License Number State |
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