# STELISE INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ENOSBURG PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225139181
- **Authorized official:** STEPHEN COMEAU (PHARMACIST)
- **Authorized official phone:** (802) 933-9200

## Contact information

- **Practice address:** 366 MAIN ST, ENOSBURG FALLS, VT 05450
- **Practice address phone:** (802) 933-9200
- **Practice address fax:** (802) 933-9220
- **Mailing address:** PO BOX 9830, SALT LAKE CITY, UT 84109-9830
- **Mailing address phone:** (877) 540-4748
- **Mailing address fax:** (801) 716-4872

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 038-0003335 | VT | Yes |

## Other

- **Enumeration date:** 09/25/2006
- **Last updated:** 01/29/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1009134 | — | VT |
| 01 | — | 2101711 | PK | — |