Organization
SOUTH HERO PHARMACY LLC
Active
Other names
South Hero Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
AUDREY MCGREGOR REARDON (PRES)
(802) 655-3544
Entity
Organization
Contact information
Practice address
334 US ROUTE 2, SOUTH HERO, VT 05486
(802) 372-5377
(802) 372-5638
Mailing address
PO BOX 277, 334 US ROUTE 2, SOUTH HERO, VT 05486
(802) 372-5377
(802) 372-5638
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
0380003129
VT
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007138
—
VT
01
—
4703129
OTHER ID NUMBER
—
Enumeration date
10/17/2006
Last updated
09/04/2014
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