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General NPI Number Information
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NPI Number | 1992927479
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Entity Type | Organization
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Legal Business Name | SHIRE APOTHECARY, INC.
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 13 ELM STREET
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City | WOODSTOCK
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State | VT
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Zip | 05091
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Country | US
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Telephone | 802-457-2707
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Fax | 802-457-3008
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Provider Business Mailing Address
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Address Line | 13 ELM STREET
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City | WOODSTOCK
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State | VT
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Zip | 05091
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Country | US
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Telephone | 802-457-2707
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Fax | 802-457-3008
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Authorized Official
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Title or Position | PRES.
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Name | MR. IMANTS VITOLS
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Credential |
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Telephone | 802-457-2707
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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 | 0350001163
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License Number State | VT
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