Organization
NIKLAS-MOORE INC
Active
Other names
Green Mountain Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SARA KAY NIKLAS PHARMD RPH (OWNER MANAGER)
(802) 824-3344
Entity
Organization
Contact information
Practice address
5700 RT 100 UNIT C-10, LONDONDERRY, VT 05148-0576
(802) 824-3344
(802) 824-3332
Mailing address
5700 RT 100 UNIT C-10, PO BOX 576, LONDONDERRY, VT 05148-0576
(802) 824-3344
(802) 824-3332
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0380003348
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011164
—
VT
Enumeration date
07/25/2006
Last updated
08/22/2020
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