Organization
EQUINOX COMPOUNDING PHARMACY
Active
Other names
EQUINOX COMPOUNDING PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP O NEILL (PRESIDENT)
(802) 442-5602
Entity
Organization
Contact information
Practice address
34B WAYS LN, MANCHESTER CENTER, VT 05255-9231
(802) 367-1096
(802) 367-1098
Mailing address
PO BOX 737, BENNINGTON, VT 05201-0737
(802) 442-5602
(802) 442-8023
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
0380003389
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014827
—
VT
01
—
2101743
PK
—
Enumeration date
12/18/2007
Last updated
11/21/2014
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