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General NPI Number Information
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NPI Number | 1801830401
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Entity Type | Organization
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Legal Business Name | TES DRUG, INC.
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 20 S MAIN ST
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City | BARRE
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State | VT
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Zip | 05641-4826
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Country | US
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Telephone | 802-479-3381
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Fax |
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Provider Business Mailing Address
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Address Line | 20 S MAIN ST
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City | BARRE
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State | VT
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Zip | 05641-4826
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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 | OWNER
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Name | MR. ERIC MOORE
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Credential |
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Telephone | 802-479-3381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 3352
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License Number State | VT
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