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General NPI Number Information
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NPI Number | 1881516102
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Entity Type | Individual
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Provider Name | REDEAT MEKURIA
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Gender | Female
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Dates
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Enumeration Date | 07/28/2026
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Last Update Date | 07/28/2026
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Provider Practice Location Address
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Address Line | 820 WATERBURY STOWE RD
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City | WATERBURY
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State | VT
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Zip | 05676-9730
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Country | US
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Telephone | 802-241-4115
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Fax |
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Provider Business Mailing Address
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Address Line | 61 N DORSET ST UNIT 415
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City | SOUTH BURLINGTON
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State | VT
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Zip | 05403-6694
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Country | US
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Telephone | 617-549-4530
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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 | 033.0136112
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License Number State | VT
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