MEDICARE: DR. CASEY POWERS PHARMD

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
1	183500000X	Pharmacist	033.0120977	VT

General Provider Information

NPI Number	:	1477008621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CASEY POWERS PHARMD

Provider Business Mailing Address
First Line	:	20 ELLIOT ST
Second Line	:
City	:	BRATTLEBORO
State	:	VT
Zip	:	05301-3216
Country	:	US
Telephone Number	:	802-254-2303
Fax Number	:	802-257-0023

Provider Business Practice Location Address
First Line	:	20 ELLIOT ST
Second Line	:
City	:	BRATTLEBORO
State	:	VT
Zip	:	05301-3216
Country	:	US
Telephone Number	:	802-254-2303
Fax Number	:	802-257-0023

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2016
Last Update Date	:	08/17/2016

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