Organization
WHITE MOUNTAIN PHARMACY INC
Active
Other names
White Mountain Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM KUZMESKUS (OWNER/PHARMACIST)
(603) 838-2000
Entity
Organization
Contact information
Practice address
21 N MAIN ST, LISBON, NH 03585-6600
(603) 838-2000
(603) 838-2000
Mailing address
21 N MAIN ST, LISBON, NH 03585-6600
(603) 838-2000
(603) 838-2000
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0789
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3061493
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
30709944
—
NH
Enumeration date
10/04/2012
Last updated
02/14/2013
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