Organization
GREEN MOUNTAIN MEDICAL STORE LLC
Active
Organization
GREEN MOUNTAIN MEDICAL STORE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITALI R ASHER (AUTHORIZED OFFICIAL)
(802) 598-2697
Entity
Organization
Contact information
Practice address
46 FOX RUN RD, ESSEX JUNCTION, VT 05452-2653
(802) 598-2697
Mailing address
46 FOX RUN RD, ESSEX JUNCTION, VT 05452-2653
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
09/06/2018
Last updated
09/06/2018
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