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NPI Code Detail

MEDICARE: GLENN HOWARD PAINE RPH

MEDICARE:   GLENN HOWARD PAINE  RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist033.0002936VT

General Provider Information

NPI Number : 1124310271
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLENN HOWARD PAINE RPH
Provider Business Mailing Address
First Line : 1823 VERMONT ROUTE 107
Second Line :
City : BETHEL
State : VT
Zip : 05032-9107
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1823 VERMONT ROUTE 107
Second Line :
City : BETHEL
State : VT
Zip : 05032-9107
Country : US
Telephone Number : 802-234-5289
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2011
Last Update Date : 05/09/2011

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Directions to “ GLENN HOWARD PAINE RPH” Practice Location

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