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Organization

GRANITE PHARMACY INC.

Active
Other names
GRANITE PHARMACY INC
Organization subpart
No

Provider details

NPI number
Authorized official
LISA DOCKHAM RPH. (PRESIDENT)
(802) 527-9930
Entity
Organization

Contact information

Practice address
576 BALLARD RD STE 2, MILTON, VT 05468-4210
(802) 527-9930
(802) 527-9764
Mailing address
576 BALLARD RD STE 2, PO BOX 2094, MILTON, VT 05468-4210
(802) 527-9930
(802) 527-9764

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336L0003X
Long Term Care Pharmacy
Primary
141-0003297
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1006503
VT
01
2101633
PK
Enumeration date
06/12/2006
Last updated
10/26/2013
About Stedi
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