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General NPI Number Information
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NPI Number | 1780639633
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Entity Type | Organization
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Legal Business Name | JOHN M BOVE
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 17 MENDON VIEW DRIVE GERICARE
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City | MENDON
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State | VT
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Zip | 05701
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Country | US
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Telephone | 802-773-3888
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Fax | 802-775-7400
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Provider Business Mailing Address
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Address Line | PO BOX 1852 STATION A, GERICARE
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City | RUTLAND
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State | VT
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Zip | 05701-1852
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Country | US
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Telephone | 802-773-3888
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Fax | 802-775-7400
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Authorized Official
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Title or Position | PHARMACIST MANAGER
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Name | MS. PATRICIA M. ABATIELL-BOVE
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Credential | RPH
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Telephone | 802-773-3888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 038-0003319
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 038-0003319
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License Number State | VT
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Taxonomy #3
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 0380003319
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License Number State | VT
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Taxonomy #4
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 038-0003319
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License Number State | VT
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